Hospital Insurance Billing Clerk
Responsible for performing routine bookkeeping and accounting functions related to the Business office. Bills all payers for all hospital and hospital-based physician bills; pursues collection of all claims until payment is made by insurance companies. Prepares monthly statements that are sent to patients. May be responsible for other business office related tasks such as accounts receivable, accounts payable, collections, general secretarial duties, insurance billing, preparing hospital bills, and bookkeeping duties. Will be responsible for taking patient payments and answering patient questions about their bills.
Desired Education, Certifications and/or Experience
High school diploma or equivalent
Knowledge of Medicaid, Medicare, and Insurance processes
Healthcare Billing experience
Responsibilities / Functional Job Description
General: Performance Expectations
Responsible - works independently, in a safe and appropriate manner. Demonstrates both problem-solving and problem-prevention skills.
Sensitive - displays sensitivity to the needs of patients and co-workers. Demonstrates good communication skills and empathy.
Timely - recognizes time as a customer's most valuable resource and responds promptly to patients' and co-workers' needs.
Accurate - works carefully and precisely, with attention to detail.
Coordinated - organizes and delivers service in the proper order. Displays good organizational skills and utilizes resources wisely.
Thorough - meets all the requirements of his/her position. Is able to evaluate and follow up on his/her services.
General: Standards of Behavior
Demonstrates a commitment to living the SLHD standards of behavior through exemplifying in action, a commitment to the values of SLHD, namely:
Innovation – continually seeking the latest advances in cost effective healthcare and customer service.
Compassion – concern for the individual, empathy for the situation, action to provide service
Integrity – doing the right thing always.
Community – supporting, giving, and acting to improve where we live, serve, and work.
Passion for Healthcare – fervently, avidly, and zealously seeking the improvement of human health
Displays this commitment to the standards of behavior through actions and words by demonstrating the following behavior traits:
Adaptability – Responding resourcefully to changes in direction, priorities, schedules, approaches, and responsibilities for the good of everyone. Maintaining a positive attitude when faced with a difficult or challenging situation and providing an uplifting and realistic outlook on the opportunities the future may present.
Communication – Listening attentively and seeking clarification, being friendly in words and actions, and responding to others in a timely manner to ensure satisfaction, comfort, and quality care. Utilizing AIDET and the promise to explain the experience the patient can expect and communicate how the patient will receive excellent and timely care.
General: Teamwork and Service Expectations
Display and encourage sensitivity to the needs of patients, visitors, and co-workers.
Treat others with consideration, courtesy, and respect.
Perform duties willingly and with initiative; share necessary information so co-workers can do the same.
Remain composed and take action to restore calm in stressful situations.
Demonstrate judgment and tact when dealing with others.
Cooperate with other hospital departments and work groups.
Communicate effectively with patients, visitors, and co-workers; take action to clarify information received from others.
Role Specific: Work role responsibilities
Prepares and submits hospital claims to all payers.
Secures needed medical documentation required or requested by all payers.
Follow up with all payers on unpaid claims until claims are paid or only self-pay balance remains.
Works with physician or medical record staff to ensure correct diagnosis/procedure codes are reported to all payers.
Keep updated on all billing and benefit changes for all payers.
Monitor claims for missing information.
Entering payments received by all payers.
Handle all inquiries, phone calls, and correspondence relating to billing and insurance claims.
May be responsible for other procedures and duties such as accounts payable, accounts receivable, collections, secretarial, reception, etc.
Provide backup coverage for the hospital front desk.
Help with getting payments for denials.
Maintains confidentiality of all information.
Enhance professional growth and development through in-service meetings, educational programs, etc.
Perform other duties as directed by the Manager of the Business Office.
Desired Knowledge, Skills & Abilities
Knowledge of state and federal regulations, policies, procedures, medical billing, and financial recordkeeping.
Knowledge of financial/revenue cycle reporting and key performance indicators for measuring and benchmarking performance
Ability to operate various office equipment
Skill in accuracy and attention to detail
Ability to perform public relations in a professional manner
Ability to maintain confidentiality
Ability to read, write legibly, and calculate mathematical figures
Ability to solve practical problems and deal with a variety of variables
Ability to work with others
Ability to manage multiple assignments/projects; meet timelines and prioritize responsibility
Ability to handle stressful situations and react appropriately
Ability to exercise good judgment in appraising situations and making decisions
Ability to work and interact effectively and positively with other staff members to build and enhance teamwork across SLMC departments
Ability to communicate to complete responsibilities effectively
Ability to use computer efficiently and read computer reports and correspondence
High proficiency with Microsoft Office products (excel, word, PowerPoint, etc.)
Equal Employment Opportunity
South Lincoln Hospital District will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability, marital status, parental status, sexual orientation, or any other category protected by law.
Americans with Disabilities Act (ADA) Statement
Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stand, walk, stoop, kneel, or crouch. The employee must regularly lift and/or move up to 20 pounds.
Position Type : Full Time
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