INSURANCE CLERK

Insurance Clerk – Medical Billing

We are seeking an experienced Insurance Clerk with strong Hospital Billing and EPIC experience to support the Revenue Cycle team. This role is responsible for processing patient billing, verifying insurance coverage, resolving billing discrepancies, following up on unpaid claims, and ensuring accurate reimbursement from insurance carriers. The ideal candidate will have prior experience working in a hospital billing environment and be comfortable handling Medicare, Medi-Cal, and Commercial insurance accounts.

Key responsibilities include:

• Process inpatient and outpatient insurance claims accurately and timely.
• Verify patient account information, charges, and insurance eligibility.
• Bill primary and secondary insurance carriers and process required adjustments.
• Follow up on denied, unpaid, or underpaid claims.
• Rebill accounts as needed and maintain claim tracking systems.
• Communicate with insurance companies regarding coverage and payment status.
• Review prior stays, transfers, and account charges for accuracy.
• Process late charges, corrections, reversals, and account adjustments.
• Maintain detailed account documentation within EPIC and billing systems.
• Respond to patient and insurance inquiries via phone, email, and correspondence.
• Maintain billing records and support revenue cycle operations.

Required qualifications include:

• High School Diploma or GED.
• Recent Hospital Billing experience (required).
• Experience using EPIC EMR/EHR system (required).
• Medical Billing experience in a healthcare setting.
• Knowledge of Commercial, Medicare, and/or Medi-Cal insurance billing.
• Strong data entry, account reconciliation, and claims follow-up skills.
• Excellent communication and customer service abilities.
• Proficient with Microsoft Office and billing software systems.

Preferred experience includes:

• Revenue Cycle or Patient Financial Services experience.
• Insurance follow-up and denial management experience.
• Bilingual skills are a plus.