SUMMARY:

The billing clerk is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. Billing clerks must possess critical thinking skills and an understanding of Medicare, and Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments based on payer contracts or government regulations. In addition, billing clerks must demonstrate proficiency with the billing system to ensure all functionality is utilized for the utmost efficient processing of claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Responsible for charge and payment entry within Electronic Medical Records (EMR).
• Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account/claim adjudication.
• Responsible for correcting, completing, and processing claims for all payer codes.
• Analyze and interpret that claims are accurately sent to insurance companies.
• Perform follow-up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports.
• Process claim appeals online or via paper claim submission.
• Assist in reconciling deposits and patient collections.
• Process refund requests.
• Communicate with the credentialing coordinator to identify and resolve claim review issues.
• Process billing calls and questions from patients and third-party carriers.
• Answer/respond to correspondence related to patient accounts. Is available to answer billing and change-related inquiries by patients, staff, Managed Care Organizations, etc.
• Identify trends, and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or Supervisor.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Successful completion of Background, MVR and DFWP Screenings.

OTHER QUALIFICATIONS:

• Must possess professional & courteous internal/external customer service skills.
• Strong organizational skills and the ability to work in a fast-paced team environment.
• Work effectively with a team.
• Ability to communicate articulately and comprehend written and verbal communications.
• Ability to function efficiently in a stressful working environment.
• Ability to work collaboratively with people of diverse cultures and lifestyles.
• Ability to communicate effectively with internal and external customers.
• Ability to problem solve independently and in a team environment.
• A minimum of 2 years of medical office experience along with basic medical terminology and billing (insurance) suggested.

EDUCATION and/or EXPERIENCE:
High School graduate.

COMPETENCIES:

• Suggested Insurance Medical billing
• Computer literacy
• Excellent written and oral communication skills
• Problem-solving skills 

BENEFITS:

• Participate in STAR and NHSC loan repayment plans through the Health Resources and Services Administration!
• Health (85% company paid) /Dental / Vision / Insurance available @ 60 days
• 50% match up to 6% of annual salary
• 11 paid holidays
• 8 hours of vacation and 8 hours of sick leave accrued monthly
• A floating holiday

Starting Point Behavioral Healthcare: Our goal is to help the people in our community live their best lives. That's why we offer aid to those in need of mental health treatment and substance abuse recovery alternatives. We provide a wide variety of programs for all ages with special behavioral health and substance abuse programs for children, teens, women, families and older adults.