Billing Clerk

at  Midland Health

Job Description:
The person handling this position is responsible for correcting, completing, and submitting claims, electronically and by paper, to all payer sources for reimbursement of services provided. The employee will monitors hospital system(s), insurance payer information, department reports and takes corrective action, to assigned accounts, if necessary to ensure proper billing and payment of receivables.

EDUCATION AND EXPERIENCE

• High School diploma or equivalency required.
• Courses in insurance billing and medical terminology preferred.
• One year experience billing hospital or professional services claims required.
• Must be able to type 35 wpm and operate a personal computer.

PHYSICAL REQUIREMENTS

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual must be able to:

• Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits.

ESSENTIAL FUNCTIONS/PERFORMANCE EXPECTATIONS

• Demonstrates the ability to compliantly resolve payer specific edits with required information existing within the patient record.
• Demonstrates the ability to produce, transmit and submit compliant claims to all payers for reimbursement.
• Accurately completes all reports in Patient Accounting System on a daily basis.
• Demonstrates the ability to correct all RTPs and other payer rejections from all payers on a daily basis.
• Monitors payer rules and regulations and implements timely changes when necessary.
• Demonstrates the ability to review and analyze ERAs/EOBs for additional information needed, claims corrections or resubmission when necessary.

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual must be able to:

• Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits