Hospital and Clinic Insurance Clerk - Business Office - Full-Time - Days
- Full Time
- More Information
Department: Business Office
Position Description: Hospital and Clinic Insurance Clerk
Status: Full-Time - 40 Hours per Week
Shift: Day - 8:00 a.m. to 4:30 p.m.
Days: Monday through Friday
This position will be responsible for performing billing and follow-up functions, including the investigation of payment delays, resulting from no response, denied, rejected and/or pending claims with the objective of appropriately maximizing reimbursements and ensuring that claims are paid in a timely manner. This position requires strong-decision making ability around complex claims processing workflows and requires utilization of data coming from multiple resources. This position has the opportunity to work remotely once the employee has demonstrated good performance.
- Resolve billing errors and edits to ensure all claims are filed in a timely manner.
- Ensure all claims are accurately transmitted daily and all appropriate documentation is sent when required.
- Verify eligibility and claims status on unpaid claims
- Review payment denials and discrepancies and take appropriate action to correct the accounts/claims.
- Respond to customer service inquiries.
- Perform charge corrections when necessary to ensure services previously billed incorrectly are billed out correctly.
- Submit replacement, cancel and appeal claims to third party payers.
- Provide timely feedback to management of identified claims issues, repetitive errors, and payer trends to expedite claims adjudication.
- Work accounts in assigned queues in accordance with departmental guidelines.
- Contact patients for needed information so claims are processed/paid in a timely manner.
- Work directly with third party payers and internal/external customers to resolve claims.
- Interpersonal skills
- Written and verbal communication
- Customer service skills
- Ability to operate a computer and basic office equipment
- Technical aptitude - ability to learn new systems quickly
- Microsoft Excel/Word/ Outlook
- Must be able to multi-task and work independently
- Past work experience of at least one year within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing medical claims processing and or financial counseling.
High School Diploma or GED.
Please fill out an application on our website, questions should be directed to Human Resources firstname.lastname@example.org or call 515-433-8448.