Overview: Department: Billing
Position: Billing Clerk 1
Employee Category: Non-Exempt
Reporting Relationship: Manager of Revenue Cycle Management
Character First Qualities: *
Decisiveness- *The ability to recognize key factors and finalize difficult decisions.
- Dependability- Fulfilling what I consented to do, even if it means unexpected sacrifice.
- Flexibility- Willingness to change plans or ideas without getting upset.
- Patience- Accepting a difficult situation without giving a deadline to remove it.
- Tolerance- Accepting others at different levels of maturity.
Summary of Duties and Responsibilities:
Under general supervision, the Billing Clerk 1 position is responsible for reviewing daily charges and adjustments entered by for accuracy, filing third-party claims, self-pay patient billing and answering billing questions from patients and staff.
Primary Duties and Responsibilities*:
- Review assigned claims daily to ensure accuracy prior to claim submission.
- Review documentation on self-pay claims to ensure that the appropriate discount is applied.
- Make billing corrections and adjustments to claims as appropriate to ensure prompt payment and accuracy of balance.
- Validate the correct payer for claim as well as verify patient eligibility when in question.
- Contact patients for missing information or clarification of documentation.
- Request documentation and/or information required to process claims; scan and upload documentation and information to patient accounts as applicable.
- Submit claims to the clearinghouse daily.
- Process secondary and tertiary claims accurately and timely to ensure payment.
- Coordinate with the Claims Resolution Specialists to assist in investigating denied claims and credit balances
- Complete rejection and rebill requests.
- Follow up on pending claims and work towards a resolution.
- Assist with patient phone calls regarding balances and benefits; advise patients of deductibles and co-payment status.
- Assist patients with payment arrangements by coordinating with a Collection Specialist. Issue individual statements when necessary on patient accounts.
- Assist the front staff with billing and eligibility related questions.
- Be familiar with the variety of programs offered at each site and be able to apply their benefits correctly to patient charges.
- Produce itemized billing requested by law firms or other agencies.
- Process DLO invoices monthly and send out all requested information from accounts.
- Create daily deposit slips on self-pay and private pay account.
- Collect Credit Card payments from patients and post to respective accounts.
- Be familiar with Dental, Behavior Health and Vision claims and processes.
- Meet established daily, weekly, monthly and annual deadlines.
- Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information.
- Follow written and verbal instructions from the Manager of Revenue Cycle Management.
- Exhibit professionalism in communication with patients, clients, insurance companies and co-workers.
- Participate in special projects.
- Support Variety Care’s accreditation as a Patient Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable. Provide leadership and work with all staff to achieve the goals of the “Triple Aim” of healthcare reform—to improve the experience of care, improve health outcomes, and decrease healthcare costs.
- Other duties as assigned.
Qualifications: Requirements, Special Skills or Knowledge:
- Minimum of high school diploma or GED, plus some experience related to the medical field.
- Minimum of one-year recent experience with third party billing in a Family Practice setting.
- Ability to accurately file third party claims and reports in a timely manner.
- Ability to communicate effectively with patients, management, front office and providers to resolve claim or account issues.
- Bilingual (Fluent in English and Spanish) preferred.
- Working knowledge of CPT codes.
- Understanding of medical terminology and protocols as well as basic knowledge of coding and anatomy are required.
- Demonstrated mastery of critical thinking, analytics, problem-solving and sound decision-making skills required.
- Demonstrated ability to interact and communicate effectively with individuals at various levels both inside and outside the organization, often in sensitive situations.
- Proficiency and clerical accuracy with Microsoft Office and practice management software systems.
- Professionalism, integrity, responsibility and dependability.
- Ability to assist and support others in a professional and respectful manner.
- Must be able to lift 25 pounds.
- Must be able to sit for extended periods of time.
- Must have excellent concentration ability.
Location: 3000 North Grand Blvd, Oklahoma City, OK 73107
Job Type: Full-time