BUSINESS OFFICE - UB BILLING CLERK

JOB SUMMARY:

Performs all duties related to the collection of accounts receivable, Primarily the billing of UB physician claims to payers utilizing our current EMR and clearinghouse. Responsible for maintaining work ques in EMR according to tasks requested by Manager. Notes every account worked. Files all insurance according to State and Federal guidelines. May be required to work insurance denials and rebill with corrections.

DUTIES AND RESPONSIBILITIES:

Billing/Coding Clerk

1. Responsible for running and sorting Discharged, Not Final Billed report focusing on unbilled claims.
2. Assists with coding and error resolution as needed.
3. Answers billing calls and helps provide patient information assistance when needed.
4. Reviews EOB’s/payments and verifies that accounts are being paid according to contract.
5. Scans in correspondence as needed. Responsible to work and follow-up on reminders daily.
6. Sends requests to medical records as needed.
7. Identifies problem accounts as well as claims processing delays and escalates to management.
8. Maintains various payers bulletins and educational updates in work area.
9. Attends/participates in all available educational opportunities to stay in compliance with insurance and government regulations.
10. Maintains patient confidentiality at all times
11. Responsible for knowing policies and being familiar with services offered.
12. Performs other job related duties as assigned by management.
13. Responsible for any billing related to Mountain View Hospital, Idaho Falls Community Hospital, Snake River Hospitalists and any other physicians or clinics the hospital group may be required to bill for.
14. The employee is required to comply with all PCI standards and other company policies and procedures for payment card acceptance and security.                                
15.  Responsible for the timely follow-up of all billed and assigned insurance accounts by running appropriate reports, utilizing online tools, and making contact with payers over the phone if needed.
16. Updates the patient account record to reflect the current actions that had been taken.
17. Acts like an owner; pulls own weight, works to achieve individual, department and hospital goals. Fully accountable, owns problems until solved.

QUALIFICATIONS:   

Education/Certification:  High school diploma or general education degree (GED).

Experience:  One to three years related experience and/or training preferred; or equivalent combination of education and experience.      

Equipment/Technology:  Ability to use clinic billing system, and operate basic computer functions and software. Must be able to toggle between Cerner, Claim Source, Evident and any other payer based websites simultaneously.

Language/Communication:  Ability to read and interpret documents such as patient statements, safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of the organization.

Mathematical Skills:  Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percentages and to draw and interpret bar graphs.

Mental Capabilities:  Ability to apply common sense to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.

Interpersonal:  Ability to work well with others.