FRONT DESK BILLING CLERK

GENERAL DESCRIPTION OF POSITION:

Responsible for insurance verification, entering all pertinent Patient information into the system, collecting and posting payments to the practice management system under the supervision of the Billing Supervisor. Will perform all duties which involve interaction with a patient in a manner which ensures the patient has a pleasant and satisfactory experience. All interactions with the patients will be in adherence to the PCMH principles, policies, and procedures. Will be required to work overtime when needed to cover all nighttime clinics and weekend clinics. Working hours are the hours designated by the clinic. Billing Clerk may be assigned to assist or provide coverage in other departments based on operational needs.

ESSENTIAL JOB FUNCTIONS: (with or without accommodations)

Duties may include but not necessarily be limited to the following:

Accurately enters data and maintains current computer files of all patient demographics, insurance and account information. Accurately enters payments received on accounts, applying payments to existing charges and appropriately ensures account balances are paid currently and correctly through third party payers as well as patient payments.

Reconciles and balances daily Deposit Slip Report. Verifies insurance benefits on new and established patients, documenting coverage, deductible and contractual conditions for billing and collection purposes. Scans in insurance cards on every visit. At every visit verifies coverage through TMHP for all Indigent and Sliding Fee Scale patients. Sets tickets to correct payer source.

Communicates with patients and family members in both English and Spanish regarding projected charges, office polices, collection procedures, all available programs (i.e. Presumptive Title V, BCCS, DSHS and HTW etc.) as necessary.

Closely monitors accounts with pending Medicaid or other funding sources. Reviews aging patient tickets and makes collection efforts and documents accordingly.

Reviews credit balance tickets assigned and refers tickets to Supervisor if adjustments and or refund requests are needed.

Assists with any statistical or special reporting required by Supervisor or Administration. Obtains required signatures on all consent forms. Ensure all patients are given a receipt for payment. Provides and documents payment arrangements for outstanding balances and follows up on payment arrangements that have been made.

Will be crossed trained in all registration all billing departments i.e. Internal Medicine, Pediatrics and WHC duties which ever apply. Will attend in-service training and SCF educational programs. Responsible for their own safety as well as the safety of others.

SPECIAL INSTRUCTIONS: This position requires handling of cash, collections, payments and billing and as such will require taking no less than five(5) consecutive days of accrued annual leave days per year. Therefore, five (5) of the accrued annual leave days will be reserved for this purpose.

POSITION DIRECTLY SUPERVISED: None

Qualifications

KNOWLEDGE, SKILLS, AND ABILITIES: (use of equipment, job related knowledge, language, etc.)

Knowledge of PCMH Model

Knowledge of SC policies and procedures

Knowledge of medical billing practices

Knowledge of ICD-9 and ICD-10 coding

Knowledge of computer software (Microsoft Word, Excel, etc.)

Knowledge in the use of electronic mail

Skilled in customer relations

Skilled in the use of a computer

Ability to provide effective customer service on a daily basis

Ability of read, write and spell correctly

Ability to maintain and effective and professional working relationship with the public and co-workers

Ability to bend, stretch, stoop, stand, sit and lift up to 20 lbs

Ability to operate a keyboard, telephone, and other office equipment

Ability to examine documents for accuracy and completeness

Ability to prepare records in accordance to detailed instructions

Ability to communicate fluently in English and Spanish

Ability to maintain a positive work environment

Ability to work in a fast paced environment

Ability to maintain a flexible work schedule

Ability to maintain client and office confidentiality

MINIMUM QUALIFICATIONS/CERTIFICATES/LICENSES/REGISTRATIONS REQUIRED:

High school diploma or GED. Graduate of an accredited Medical Office Specialist program with minimum of one year billing experience in a medical or hospital setting or two years billing in a medical or hospital setting. Applicants must be familiar with private insurance, Medicare and Medicaid claims filing. Experience with CPT and ICD-9 and ICD-10 coding.

SPECIAL INSTRUCTIONS: This position requires handling cash, collections, payments, billing, purchasing or inventory duties and as such will require taking no less than five (5) consecutive days of accrued annual leave days per year. Therefore, five of the accrued annual leave days will be reserved for this purpose.

This position requires travel. Employee must provide transportation. If employee operates a personal motor vehicle in the performance of their official duties, the employee must possess a current valid Texas drivers license for the appropriate type of vehicle and Texas Liability insurance. This position requires that an employees driving record be verified with law enforcement to ensure compliance with SCs driving policy

Due to the nature of SC Services, it may be necessary for employees to work extended hours or other variations of the usual shift to ensure adequate care to patients and to maintain service to the community.