INSURANCE CLERK

Job Summary:

• Works under the supervision of the Business Services Coordinator.
• Performs diverse clerical tasks involved in processing of billing for services to patients in order to expedite remittances and minimize outstanding accounts.
• Checks for prior stays and charges.
• Resolves questions through written correspondence, in person or by telephone.
• Performs other duties as assigned.

Key Responsibilities:

• Greets patient and public politely.
• Composes and types letters.
• Verifies information/charges on patient account for accuracy, reconciles discrepancies.
• Maintains records and files account transaction, hard copy and computer system.
• Answers inquiries accurately and courteously by phone or in person.
• Observant of co-members desk when vacant.
• Enters detailed comments into the computer.
• Obtains documents from outside departments to obtain required or necessary information to complete verification/billing process.
• Checks admissions for prior stays and transfers charges from outpatients (if applicable).
• Receives, interprets and processes any incoming mail/bulletins, submits necessary modifications if applicable.
• Processes late charges and completes spreadsheet if applicable.
• Downloads claims to PC from Host systems if applicable.
• Bills both primary and secondary insurance carriers for inpatients and outpatients, process required adjustments, calculates days and deductibles if applicable, at the time of billing calculates expected payments, and adjusts balances.
• Rebills accounts when necessary.
• Maintains a system for review and follow-up on un-paid claims. Files liens when necessary.
• Completes claim check process to produce bills and enters, corrects, or reverses charges when necessary with required documentation.
• Refers accounts to a self pay status when collection efforts have been exhausted or denied.
• Interprets for Non-English speaking patients/public.
• Communicates with insurance carriers to ensure coverage for services provided.

Education:

• High school diploma or GED.