Patient Business Services Clerk

About the position

The Patient Business Services Clerk position at the County of Santa Clara involves maintaining complex and varied acute care and outpatient medical accounts. The role focuses on either billing and accounts adjusting or collecting and researching problem accounts, ensuring accurate billing and compliance with regulations.

Responsibilities

• Reviews, checks, researches, and completes pre-billing information to prepare billing statements for patients and other payors.
• Compares summary claims against detailed itemization of charges.
• Combines inpatient and outpatient accounts of individual patients.
• Initiates various adjustments and transfers within patient accounts receivable.
• Calculates leftover charges and bills secondary payor after payment by a primary payor.
• Adjusts accounts, justifies, and totals designated uncollectible charges or bills.
• Breaks down charges as billable or not according to various insurance coverage.
• Reviews prepared bills for errors.
• Researches and reopens closed accounts to apply further payments received.
• Researches individual accounts to determine whether over-payments can be applied to another account or should be refunded.
• Researches accounts subject to bankruptcy proceedings and determines whether to adjust account balances or assign for collection externally.
• Reviews insurance covered accounts to ensure claims were valid and properly submitted.
• Researches billing, accounts, and remittance records to track and explain account problems and discrepancies.
• Notifies patients of their liability when uninsured or when insurance does not cover entire charges, and prepares reimbursement plans.
• Determines whether to refer a delinquent account to a collection agency or recycle it for review in the next period.
• Assists in orienting new employees to procedures and assignments in the unit.
• May prepare spreadsheets on more complicated accounts.
• May interview patients to determine ability to pay and establish a payment plan.

Requirements

• Demonstrated education, training, or clerical work experience in billing, collection, or accounting.
• Knowledge of medical terminology and insurance claim procedures common to medical billing and accounts receivable operations.
• Knowledge of billing and account records maintenance procedures.
• Familiarity with modern office administrative practices and procedures including computer skills.
• Understanding of International Classification of Disease Standards and Concurrent Procedure Terminology.
• Ability to operate a ten key adding machine and make arithmetical computations of moderate difficulty.
• Ability to understand and apply moderately complex medical services, insurance, and billing or accounts maintenance relationships.

Nice-to-haves

• Experience in a medical setting outside of the County's medical services.

Benefits

• Excellent Benefits, including Medical, Dental, and Vision coverage.