Responsible for working outstanding insurance claims having no response from payors, having edits, and having received claim form related denials. Maintains A/R at acceptable aging levels by prompt follow-up of unpaid claims and denied claims. Provide information over the phone for billing related questions directed to the central business office. Review credit balances for possible refunds. Perform all duties in a manner which promotes team concept and reflects the clinic's mission and philosophy. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Thoroughly and timely work follow up records in work queues as defined by policies and procedures. Process insurance claims correspondence. Read and interpret EOB's (Explanation of Benefits) Process appropriate refund in accordance with department policies and procedures. Present unresolved concerns to Supervisor for resolution immediately with related documentation. Document account activity accurately and promptly during or immediately following each processed encounter. Responsible for the accurate and timely submission of claims, denials, and re-bills of insurance claims. Responsible for the analysis and necessary corrections of patient accounts as it pertains to clean claim submissions or re-bills. Responsible for maintaining work queues . Responsible for telephone and/or written correspondence with insurance companies for claims follow up. Responsible for correctly identifying and updating various types of insurance entry information. Maintain basic understanding and knowledge of health insurance plans, policies and procedures. Make suggestions on improving Clinic procedures to improve billing accuracy and collections. Must be accepting of diversity and willing to participate in a team environment; as well as, willingness to follow clinic policies and procedures as established. Must attend all required staff meetings, in-service meetings and participate in task force activities. SKILLS and ABILITIES Demonstrated customer service expertise. Keyboarding minimum 40 wpm. Accurate 10 key by touch. Skilled at using Microsoft Office products, particularly Microsoft Word and Excel. EDUCATION AND EXPERIENCES: High school diploma or equivalent. Minimum of one year of experience in health care medical billing required. Experience with private insurance billing and collections regulations experience preferred. Experience with government, commercial, and third-party insurance contract practices and claims processing procedures preferred.
Pay Range:
$19.22 - $26.91
The above information is intended to indicate the general nature and level of work required in this position. It is not designed to contain or be interpreted as a comprehensive description of all duties, responsibilities, and qualifications required of those assigned to this job. We offer a competitive Total Rewards Program. Eligibility for benefits is dependent on factors such as position type and FTE. Benefit-eligible employees qualify for benefits beginning on the first of the month following one month of employment. Vancouver Clinic offers medical, dental, vision, life insurance, AD&D, long term disability, health savings account, flexible spending account, employee assistance program, and multiple supplemental benefits (voluntary life, critical illness, accident, hospital indemnity, identity theft protection, legal services, etc.). We also offer a 401k retirement plan, with employer contributions after your first year of employment. Benefits-eligible employees accrue PTO and Personal Time based on hours worked and State worked, totaling 120 hours in the first year for full time staff and 200 hours in the first year for full time supervisors and above, increasing in subsequent years. PTO and Personal Time accruals are pro-rated by FTE/hours worked. Non-benefits eligible employees will accrue Personal Time based on hours worked and State worked. Employees will also enjoy up to six paid holidays per year, depending on schedule. Contact your recruiter for more information.
Vancouver Clinic is proud to be an Equal Opportunity Employer. Vancouver Clinic does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, gender identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Vancouver Clinic is an alcohol and drug-free workplace. Offers are contingent on successful completion of background screen and immunization requirements.
