SHS-BILLING CLERK

Job Opportunity

Perform duties to bring about the proper billing of all inpatient and outpatient accounts. Follow up on all accounts until paid in full or until the account balance becomes private pay.

Essential Duties :

• Provide insurance companies with copies of bills, via electronic or manual billing.
• Verify that the proper demographic and insurance information has been obtained to ensure that only accurate clean bills are forwarded to insurance companies and patients.
• Handle incoming and outgoing telephone calls to patients / families and insurance companies.
• Bill secondary insurance companies as required.
• Work accounts to resolution utilizing the appropriate tools, i.e. Workstation, aging reports, special project reports to secure pmt. from responsible payer.
• Work unpaid high dollar priority balances : a) send status to secure payment; b) call insurance companies to ask for unpaid balance; c) identify and take appropriate corrective action for insurance over and underpayments; d) bill patients for private pay balances.
• Process mail pertaining to accounts.
• Responsible for providing supervisor with weekly statistics of claims submitted.
• Responsible for understanding corporate compliance rules and regulations as it relates to billing.
• Maintain confidentiality regarding patient bills & records.
• Serves as a role model for consistent demonstration of Sparrow Health System's Customer Service Behavioral Standards of Performance, by respecting the Privacy and Confidentiality of those we serve.
• Demonstrates knowledge and respects patient, service provider, and organizational confidentiality and HIPAA Security procedures and protocols as defined under the HIPAA Privacy and Security Procedures.
• Follows established HIPAA privacy procedures when using and / or disclosing protected health information.
• Maintains and protects patients' rights under the HIPAA Privacy standards.

Job Requirements

General Requirements : None

Work Experience : See education

Education : Billing Certificate from an Accredited School / College; OR High School Diploma or GED and a minimum of 1 (one) year of medical billing experience in a health care environment

Specialized Knowledge and Skills : Demonstrated knowledge of medical terminology as would normally be obtained through successful completion of a medical terminology course. Demonstrated excellent communication and interpersonal skills. Demonstrated knowledge / understanding of ICD-10 and CPT-4 coding. Demonstrates ability to use a keyboard as may be required to perform the essential duties of the job. Working knowledge of Uniform Billing Guidelines, NCCI / MUE / OCE / LCD editing and generalized insurance follow-up workflows. May be required to take test of billing knowledge prior to hiring. Must possess strong analytical thinking and customer service skills. Testing will be used to identify strongest candidates. Knowledge of UB04 Billing form - preferred