Department Name: Billing
Position Title: Billing Clerk
Position Reports to: Billing Coordinator
FLSA Requirements:
Date Issued:
Location:

JOB STATEMENT/SUMMARY

The billing clerk ensures proper submission and collection of patient fees by performing various tasks related to insurance credentialing, submission of insurance claims, and preparing/submitting invoices and bills.

JOB REQUIREMENTS AND PREFERRED QUALIFICATIONS

Competencies

• Collaboration
• Communication
• Analysis
• Reasoning
• Ethical Practice
• Computation
• Computer skills
• Medical terminology

Education (level and type) and Related Work Experience
High school diploma or general education degree (GED), and one to three years related experience and/or training. An equivalent combination of education and experience will be considered. Computer skills and medical terminology fluency required.
Safety & Health
Employees are expected to follow CHS safety and health policies.
Supervisory Responsibilities
This job has NO supervisory responsibilities.

DISCLAIMER

This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time.

• Gathers necessary information (e.g., provider information, officer signatures, etc.) to submit provider credentialing forms to insurance payers.
• Submits provider credentialing forms to insurance payers.
• Ensures all new providers are credentialed with insurance payers, and periodically re-credentials existing providers.
• Maintains a comprehensive spreadsheet of credentialing (e.g., provider names, insurance names, date of initial credentialing, most recent date of re-credentialing, etc.).
• Maintains a comprehensive list of contacts for each insurance payer.
• Maintains a file on all providers with necessary documentation for insurance credentialing.
• Shares credentialing information with Human Resources, as needed, for provider personnel files.
• Prepares and transmits (e.g., via mail, electronically) all billing for primary and secondary insurance claims.
• Posts payments per accounts receivable policy and procedure, maintaining an accurate record of payments posted.
• Corrects returned claims or routes claims to appropriate personnel in a timely manner.
• Prints patient statements and collection letters according to collections policy and procedure.
• Writes off overdue accounts prior to closing each according to collections policy and procedure.
• Completes overpayment forms for Medicare, Medicaid, and commercial insurance payers in accordance with regulations.
• Communicates with insurance payers to clarify incorrect remittance, duplicate payments, etc.
• Addresses billing calls from third party payers and patients.
• Prepares and sends refund checks to patients or insurance companies.
• Maintains records for Medicare bad debts as required for annual audit.
• Maintains current medical coding and diagnosis information for appropriate billing practices.
• Performs other duties as assigned.