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Billing Clerk
Billing ClerkDenton County MHMR • Denton, TX, United States
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Billing Clerk

Billing Clerk

Denton County MHMR • Denton, TX, United States
16 days ago
Job type
  • Full-time
Job description
Billing Clerk

Under direction of the Director of Revenue Cycle Reimbursement and within federal, state, and local guidelines provides assistance with reimbursement or claims processing work. Work involves determining eligibility, obtaining financial information, maintaining accounts, and processing of receivables. Provides assistance with researching and processing all refunds, appeals, rejected and denied claims for all payers.

Performs advanced reimbursement or claims processing work. Work includes transmission of 837 claims files and processing of 835 payment files. Work involves determining eligibility; obtaining financial information; maintaining accounts; and collecting charges for the support, maintenance, and treatment provided to individuals served. Work includes entering, maintaining, and monitoring authorization in the billing systems. Work includes analytical review of clinical system for billing and/or accounting issues. Works under general supervision, with moderate latitude in the use of initiative and independent judgment.

Education, Training, and Experience

  • High School Diploma or equivalent required. Prefer some college with course work in accounting.
  • At least one (1) year prior experience in claims processing and health-related account and collection work, ICD 9, DSM IV and CPT coding preferred. Prior experience with a Clinical Electronic Health Record is required.
  • Experience with Medicare and Medicaid is highly preferred. Experience with Microsoft Excel is required.
  • Working knowledge of computers in a Windows based environment, including strong data entry skills. Experience with Microsoft Excel is required.
  • Must possess excellent analytical, communication, organizational and interpersonal skills.
Registration, Certification, Licensure, and Other Qualifications
  • Must have and maintain a background and criminal history free from any disqualifying offenses as outlined by the Texas Administrative Code (TAC) and the Health and Human Services Commission (HHSC).
  • Must possess and maintain a valid driver's license and automobile insurance.
    • Individuals with an out-of-state driver's license must be able to obtain a driver's license in the state of Texas within thirty (30) days.
  • Successful completion of all position-specific training within thirty (30) days of employment is required.
Knowledge, Skills, and Abilities
  • Knowledge of the principles of collection and accounting, and of the rules and regulation governing reimbursement for agency services. Proficient reading, writing, grammar, and mathematics skills; interpersonal relations and communicative skills.
  • Skills in using general office equipment and computers. Skill in oral and written communication, being able to handle multiple tasks and prioritizing spreadsheet, data entry, and database management.
  • Skills in resolving problems, reviewing and evaluation options, implementing solutions, using general office equipment and computers, and interview techniques.
  • Ability to communicate effectively orally and in writing, and to plan, assign, and/or supervise the work of others
  • Ability to maintain confidential and sensitive information
  • Ability to proofread.
  • Ability to learn new or revised regulations.
  • Ability to be courteous and tactful when dealing with difficult people.
  • Ability to solve practical problems and deal with a variety of concrete variable in situations where only limited standardization exists.
  • Daily activities include frequent interruptions.
  • Ability to display regular and reliable (in-person, if required) attendance.
  • Understanding and practice of Trauma Informed Care principles.

Essential Duties

The following list outlines key responsibilities for the position; however, it is not exhaustive and does not encompass all responsibilities. Additional duties may be assigned as needed.

Maintain strict confidentiality of consumer and fiscal data. Adhere to Center wide Policies and Procedures and demonstrates knowledge by compliance with policies and procedures.

  1. Downloads and processes electronic payments and prepares Excel reports on payments and denials of claims by various funding sources.
    • All electronic payments are processed and exception reports are distributed as needed within the month
  2. Reviews denied or rejected claims, investigating causes, submitting appeals, and/or correcting errors for resubmission. Monitors aging reports to follow up on unpaid claims.
  3. Oversee the maintenance of the client eligibility data within the Electronic Health Record (EHR).
  4. All consumer and eligibility data is to be maintained in SmartCare.
  5. Assists with payer setup on client accounts to include adding/updating coverage plans and client charges.
  6. Maintain strict confidentiality of consumer and fiscal data according to HIPAA and other laws and regulations. Adhere to all billing and claims regulations and demonstrates knowledge by compliance.
  7. Successful completion of all staff development training as required for position. Completion of all staff development training is completed as required by DCMHMR policy with no deficiencies.
  8. Perform additional duties as deemed necessary by department supervisor within designated timeframes. Cross train in all billing functions.
  9. HIPPA and billing/claims regulations are adhered to with no deficiencies.
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Billing Clerk • Denton, TX, United States

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