Central Health

  • Medical Billing Clerk, Senior

    Req No.
    2018-3482
    Company
    CommUnityCare Health Centers
    Name
    Kramer
    Address
    2115 Kramer Lane, Suite 100
    City
    Austin
    Category
    Administrative
    State
    TX
    Type
    Regular Full-Time
    Shift Days
    Monday - Friday
    Shift Hours
    8am-5pm (Flexible)
  • Overview

    In collaboration with patients, families (as defined by the patient) and staff across all disciplines and departments is responsible performing complex tasks relating to verification of clinic patients’ insurance coverage, collection of third party insurance submissions, resolution of aging accounts, and client customer service.

    Responsibilities

    • Review billing data from electronic office records to ensure amounts and account numbers are accurate and submit claims to public and private payers.
    • Review complex denials and refund requests, dispute or appeal as necessary.
    • Contact vendors regarding denials or benefit coverage.
    • Maintain, track and report grant payment and denials.
    • Maintain and submit Medicare Credit Balance report by tracking billing, monitoring collections, and compiling information.
    • Research, identify and facilitate resolution to complex problems with overdue or unpaid accounts.
    • Review and process patient and insurance refund requests.
    • Answer and resolve telephone inquiries from internal and external sources.
    • Perform other duties as assigned.

    PRIMARY ACCOUNTABILITIES

    • Ensure the accurate and timely billing and collection of medical claims.
    • Ensure all billing and collection efforts contribute to a positive patient experience and that all patient inquiries, complaints, and requests for assistance are addressed in a timely and professional manner.
    • Develop and maintain positive working relationships with patients, co-workers, vendors, third party payor resources and related entities.
    • Maintain up-to-date knowledge of medical billing processes and procedures and take the initiative to seek out additional information as needed.
    • Ensure all actions, job performance, personal conduct and communications represent CommUnityCare in a highly professional manner at all times.
    • Uphold and ensure compliance and attention to all company policies and procedures as well as
      the overall mission and values of the organization.

    Qualifications

    • High level of skill at building relationships and providing excellent customer service.
    • Ability to utilize computers for data entry, research, and information retrieval.
    • Strong attention to detail and accuracy.
    • Ability to multitask.
    • Excellent verbal and written communication skills.
    • Ability to understand complex insurance issues, including assigning correct payer, adjustments
    • and refunds to accounts.

    Education:

    • High school diploma or equivalent.

    Knowledge and Experience:

    • 2 years of medical billing experience.
    • Demonstrated knowledge of administrative and clerical procedures and systems such as word processing and database systems, filing and records management systems, transcription, and other office procedures and terminology.
    • Solid knowledge of billing and collections processes and procedures.
    • Solid knowledge of NextGen EPM or other medical billing software.
    • Demonstrated knowledge of Medicare, Medicaid and other third party insurers.
    • Demonstrated familiarity and experience in the use of computer and commonly used software
      including but not limited to Microsoft Office Suite.

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