Insurance Clerk

About the role

Responsible for the insurance billing process between the hospital and insurance companies, federal agencies, and third-party payers. Audits patient accounts to ensure procedure, charges, and coding accuracy. Collects payments from commercial insurance companies, state, and federal agencies.

Responsibilities

• Coordinates the payment process and collects payments from insurance companies, federal and state agencies, and third-party payers.
• Maintains a professional working relationship with the insurance companies, government agencies, and third-party payers.
• Responsible for contacting the appropriate agency/company to resolve account collection problems.
• Works independently to resolve account problems.
• Communicates to the Business Office Manager those accounts that need to be sent to the collection agency after all collection efforts have been exhausted by the hospital.
• Reviews patient accounts to ensure procedures have been properly coded and the charges are correct.
• Adjusts patient’s bills to reflect credits, debits, and balances.
• Collects balance due from patients when appropriate according to policy and procedure.
• Documents all correspondence and conversations with insurance companies, governmental agencies, third-party payers, and patients on patient’s account.
• Stays informed of changes in the insurance industry.
• Consults with other hospital departments to obtain or verify billing information.
• Always accepts other assignments as needed.
• Demonstrates the ability to be flexible, organized, and function well in stressful situations.
• Communicates clearly and accurately with the Business Office Manager.
• Interacts with patients/families in a professional manner; ensures confidentiality of patient records.
• Maintains a good working relationship within the department and with other departments of the hospital.
• Reports to work on time and as scheduled; completes work within the designated time frame.
• Performs other duties as assigned.

Requirements

• Previous billing experience in a healthcare setting preferred.
• Basic computer knowledge and data entry skills.
• Thorough understanding of Medicare, Medicaid, HMO's, PPO's, private insurance companies, etc.
• Ability to proficiently perform all essential job responsibilities after three-month orientation period.
• High school diploma or GED state certification.
• Completion of 5 basic units of DCH education per year.
• DCH mandatory annual training.
• Ability to read, legibly write, and comprehend medical terminology, follow instructions, and perform simple mathematical calculations.

Schedule

8am-5pm, Monday-Friday