MAIN FUNCTION: The Billing Clerk is responsible for managing the full scope of Medicaid, Medicare, Insurance, Sliding Scale and client billing, as well as all provider credentialing.
DUTIES AND RESPONSIBILITIES:
Data entry of all client invoices
Creation of HCFA’s to obtain third party reimbursement
Assists Executive Director with reports
Answers client’s questions regarding billing statements
Responsible for accounts receivable (billing, write-offs, adjustments, etc.)
**Apply all EFT insurance payments where the remit goes directly into InSync for easy application of payment. This will also include probation voucher payments.
**Apply paper checks that come in the mail.
**Pay close attention to payment detail such as incorrect payment amounts and incorrect denials.
**Responsible for secondary insurance claim submission after primary insurance payment has been applied.
**Working insurance denials and recoups- research any recoups and incorrect denials.
Work Aging Report MONTHLY - Print Aging report for all insurance companies.
Create Log ins for all Insurance Websites to access reconsideration tools.
Maintain Grant Spreadsheets
Attend insurance company zoom meetings if applicable to role (Medicaid Town Halls, BCBS trainings on new tools on their portals, etc.)
Credentialing and re-credentialing all providers as needed by insurance companies
Conducting a yearly NPDB (National Practitioner Data Bank) check for each provider
Conducting a monthly OIG (Office of Inspector General) report for each provider
Ensure yearly Medicaid site visits are up to date per state regulations
This position is supervised by: BILLING CLERK ADMINISTRATOR
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
Good communication skills, both written and oral
Good social skills, personable
Maintain confidentiality of all client information
Ability to readily move from one task to another with an equal ability to stay at one task for long periods when necessary
Ability to follow directions, make decisions
Ability to build and maintain rapport with other staff
Ability to work independently
Knowledge or willingness to learn various software programs
Must comply with all Heartland Counseling Services, Inc. rules and regulations, policies and procedures, including those regarding conduct and confidentiality
Assists with other office duties as assigned
Attention to detail with regard to data entry
TRAINING AND EXPERIENCE GUIDELINES:
Associates Degree in billing and coding.
Prior experience in credentialing and billing required. Medicaid credentialing a plus.