Insurance Billing Clerk (Physician Office)

Greene County General Hospital - Linton, IN

Full-time

Linton, IN

Nursing and Residential Care Facilities

About the position

The position involves billing all insurance companies, excluding Medicare, for hospital services. The primary responsibility is to pursue the collection of all claims until payment is received from the insurance companies. This role also encompasses various tasks associated with the billing process, including compiling necessary information for external sources, such as attorneys. The individual will prepare and submit hospital claims to third-party insurance carriers, either electronically or via hard copy. It is essential to secure the required medical documentation requested by these insurance companies and to follow up on unpaid claims until they are resolved or only a self-pay balance remains. In addition to submitting claims, the role requires processing rejections by either making accounts private, generating letters of rejection to patients, or correcting any billing errors and resubmitting claims to the appropriate insurance carriers. The individual will collaborate with physicians or medical record staff to ensure that the correct diagnoses and procedures are reported to the insurance companies. If claims remain unpaid after the established time frames, the individual will make accounts private and notify patients accordingly. Keeping updated on all billing and benefit changes for third-party insurance carriers is crucial, as is posting third-party insurance remittance vouchers and monitoring claims for missing information or authorization numbers. The position also involves sending appeals and adjustments on claims for issues such as lack of pre-certification, late charges, and incorrect billing. The individual will compile itemized bills for patients upon request from attorneys and must maintain strict confidentiality of all information. Completing work within authorized time frames is necessary to ensure compliance with departmental standards. The individual will also need to stay informed about third-party billing requirements and changes for various insurance types, including Medicaid and Blue Cross/Blue Shield. Furthermore, the role requires collaboration with the Physical Therapy department on pre-certifications and authorizations through Worker's Compensation, Auto Insurance, and other third-party payers. Other duties may be assigned as needed.

Responsibilities

• Prepares and submits hospital claims to third party insurance carriers either electronically or by hard copy billing.
• Secures needed medical documentation required or requested by third party insurances.
• Follows-up with third party insurance carriers on unpaid claims until claims are paid or only self pay balance remains.
• Processes rejections by either making accounts private or generating a letter of rejection to patient, or corrects any billing error and resubmits claims to third party insurance carriers.
• Works with physician or medical record staff to ensure that correct diagnosis/procedures are reported to third party insurance carriers.
• Makes accounts private and notifies patients when claims have not been paid, after time frames established for accounts receivable policy.
• Keeps updated on all billing and benefit changes for third party insurance carriers.
• Posts third party insurance remittance vouchers.
• Monitors claims for missing information, authorization/control numbers.
• Sends appeals and adjustments on claims for issues such as no precertification, late charges, and incorrect charging.
• Compile itemized bills for patients at the request of attorney(s).
• Maintains strict confidentiality of all information.
• Completes work within authorized time to assure compliance with departmental standards.
• Keeps updated on all third party billing requirements and changes for insurance types within their area of responsibility, such as Medicaid and Blue Cross/Blue Shield.
• Demonstrates knowledge of, and supports, hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
• Works with Physical Therapy department on pre-certifications and authorizations through Worker's Compensation, Auto Insurance and other third party payers.

Requirements

• High School diploma or GED required; Associates preferred.
• Specialized training in Insurance billing and data entry is a plus.
• At least one year prior experience in billing of third party insurances for professional services is required.
• Ability to file insurance claims by hard copy and electronically is essential.
• Good verbal and written communication skills are essential.
• Ability to effectively communicate and interact with colleagues, hospital staff, patients, public, physicians and their staff and third party insurance personnel.
• Ability to work under stress, with interruptions and deadlines.