Job Description

Job Description

Essential Functions:

1. Processes insurance claims in a timely manner.
2. Prepares insurance forms and associated correspondence.
3. Assists patients in preparing insurance forms.
4. Answers patient questions about unpaid balances.
5. Verifies balances and refunds for accuracy.
6. Follows up with insurance companies ensuring that claims are paid.
7. Maintains strict confidentiality related to medical records and other data.
8. Participates in professional development efforts to ensure currency in health care practices and trends.
9. Pre-certifies insurance for any diagnostic testing.
10. Run eligibility reports to verify insurance is current.
11. Calls patients with no insurance the day before appointment to discuss how much they will need to pay when services are rendered.
12. Talks with patients in office with no insurance before appointment to discuss payment for services.

The job holder must demonstrate current competencies applicable to the job position.

Education: High school graduate or GED. Associate degree in business administration or secretarial program preferred.

Experience: Minimum of one year of medical office billing experience.

Knowledge:

• Knowledge of clinic policies and procedures.
• Knowledge of medical terminology and insurance practices.
• Knowledge of computer programs and applications.
• Knowledge of grammar, spelling and punctuation to type correspondence.

Skills:

• Skill in gathering, interpreting and reporting insurance information.
• Skill in trouble-shooting insurance problems and claims.
• Skill in written and verbal communication.

Abilities:

1. Ability to identify claim problems and recommend solutions.
2. Ability to sort and file insurance forms and associated information.
3. Ability to work effectively with patients, employees and the public.

Environmental/Working Conditions:

Normal office environment. May view computer screens for extended periods of time.

Physical/Mental Demands:

Work requires hand dexterity for office machine operation, stooping and bending to files and supplies, mobility to complete errands, or sitting for extended periods of time.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.

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