Administrative Assistant: Medical Billing Clerk LTE
General Summary
The medical billing clerk will support the Client Account Specialist by preparing and submitting medical claims to insurance companies and following up on denied claims in the Door County Department of Health and Human Services. This role involves communication with insurance providers, clinic staff, and patients, and includes managing payments from Medicare, Medicaid, and private insurers in compliance with policies and procedures from the Center for Medicare and Medicaid Services. Regular attendance and punctuality along with being prepared to commence work at designated work locations, on the assigned or scheduled days and hours is expected. This position is responsible for providing truthful and accurate written and verbal communications.
Duties and Responsibilities
Essential Job Functions
1. Processes and submits medical claims to insurance companies.
2. Reviews and assists with resolution of claim denials from insurance companies. Resolves issues and resubmits claims.
3. Follows-up on outstanding claims within timely filing limits set by insurance companies.
4. Submits timely crossover/secondary claims for reimbursement to Medicaid, Medicare and supplemental insurance companies.
5. Maintains up to date knowledge of insurance guidelines for Medicaid, Medicare and private insurance companies.
6. Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.
General Job Functions
1. Assist the Client Account Specialist in identifying billing issues.
2. Conduct research regarding billing and account information.
3. Maintain current records of patient demographic information in the collection process.
4. Performs administrative tasks, including phone calls, emails, and report preparation.
5. Ensures compliance with standard procedures and policies in performing job operations.
6. Follow County’s policies on maintaining confidentiality of all client clinical and billing records.
Requirements
Required Training and Experience
1. One (1) or more years of progressive work experience in an office setting.
2. Proficient in entering data into electronic systems.
3. Adept at courteously interacting with patients to explain payment plans.
Knowledge, Skills, and Abilities Required
1. Ability and skill in use and operation of a personal computer is required (knowledge of Microsoft Excel and Word highly desirable). Experience with electronic health record programs desirable.
2. Ability to follow instructions and complete work within established deadlines with a high degree of accuracy.
3. Strong interpersonal skills with the ability to communicate effectively with others.
4. Strong organizational skills with the ability to multi-task and meet deadlines.
5. Ability to set work priorities, and adapt to change in technology and work environment.
6. Strong analytical and problem-solving abilities. Good mathematical aptitude.
7. Ability to follow the County’s policies on maintaining the confidentiality of all client clinical and billing records.
8. Displays professionalism and has an effective working relationship with department employees, county supervisors, county officials, and general public.
Physical & Working Conditions
Nearly 100% of time work is performed in a normal office setting with little or no discomfort from temperature, dust or noise. Interacting with other employees, general public, whether walking in or on the telephone may be encountered.
Over 75% of work is performed stationary at a desk, working on a computer keyboard and/or telephone with about 10% of work performed moving around the organization. Over 75% of the work is performed by talking, hearing, and using both far and near vision. Occasional moving of items is required up to 10 lbs. (i.e. paper or equipment).
In an effort to provide for continuity of County government and to cope with the problems of the emergency, you may be required to work during a proclaimed state of emergency, consistent with Sec. 323.14, Wis. Stats. and County emergency management plans and programs.
The above is intended to describe the general content of the requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements. They may be subject to change at any time due to reasonable accommodation or other reasons.
Deadline Note: