Prescription Center-Infusion--Billing Clerk

Description

JOB SUMMARY: Performs all duties related to billing and accounts receivable. Responsible for maintaining patient accounts from the time therapy starts, billed, and until payment is received. Notes every account worked. Assists with authorizations as needed. Follow and verify all authorizations before billing.

DUTIES AND RESPONSIBILITIES: Billing Clerk
1. In a professional and friendly manner, answers incoming phone calls transferred to admissions, preauthorization, and billing department. Answers admission, preauthorization, and billing questions from patients, co-workers and providers.
2. Secures physician orders and uses all patient information for charting, billing and record keeping purposes.
3. Verifies all patients have appropriate diagnosis and billing codes for each therapy to support medical necessity according to LCD’s and payer policies, when submitting patient billings.
4. Keys charge information into billing and software program and produce billing.
5. Follows all patient billings and works on denied claims in a timely manner. Works closely with insurance companies to correct denied claims.
6. Processes appeals on accounts when appropriate.
7. Responsible for rebilling claims when required. Responsible for contacting responsible party if additional information is requested for billing purposes. Responsible for notifying insured of insurance denials as requested. .
8. Reviews EOB’s/payments and verifies that accounts are being paid according to contract as needed.
9. Maintains flexibility as department grows with willingness to accept additional responsibilities requested by department manager/supervisor/director.
10. Acts professional in every situation: patient, co-worker or intradepartmental.
11. Protects information that is sensitive, proprietary or confidential in nature. Adheres to Patient Rights Policy and patient confidentiality standards.
12. Works to provide functional and safe surroundings for patients and staff (i.e., safety, security, infection control, etc.). Strives to always promote personal and patient safety. Demonstrates awareness of the location of applicable hospital and department specific manuals.
13. Completes all annual mandatory education requirements (including hospital, department, and job specific competencies).
14. Attends the required number of staff meetings per department standard.\\
15. Ready to work at designated start time.
16. Is willing to do assignments, cross-training, or tasks as asked by the supervisor and/or manager, which are deemed necessary to meet the needs of the department.
17. Maintains adaptability. Adapts to change in a positive and professional manner. Accepts responsibility for his/her actions, attitudes and mistakes without placing blame.
18. Is accountable for completing all assigned responsibilities/tasks and takes action when opportunities to improve are identified.
19. Promotes effective working relationship and works effectively as a part of the department/team to facilitate the hospital and department’s ability to meet its goals and objectives.
20. Employee is required to comply with all PCI standards and other company policies and procedures for payment card acceptance and security.

Qualifications

QUALIFICATIONS:

Education: High School graduate or equivalent.
Experience: Prior experience with coding and billing for outpatient services is preferred.
Language/Communication: Ability to communicate wellwith patients, co-workers and vendor representatives.
Mathematical Skills: Ability to add, subtract, multiply, anddivide in all units of measure, using whole numbers, common fractions, and decimals. Ability to determine correct number of units billed for each drug code.
Mental Capabilities: Continuously able to concentrate on fine detail with interruptions and continuously able to attend to task/function for an extended period of time. Ability to learn computer programs and input data as required.
Interpersonal: Ability to work well with others.