Medical Billing Clerk

Description

The Medical Billing Clerk is responsible for accurately preparing and submitting claims for Suburban Home Health. This role ensures timely reimbursement from Medicare, Medicaid, private insurance, and private pay sources while maintaining compliance with all federal, state, and payer regulations.

• Accurately enter patient demographics, insurance information, authorizations, and services into the billing system.
• Conduct benefit checks and insurance verification to confirm coverage, eligibility, co-pays, deductibles, and authorization requirements prior to billing.
• Verify patient eligibility, authorizations, and insurance coverage prior to billing.
• Accurately post payments, adjustments, and denials into the billing system.
• Communicate with insurance companies, patients, and internal staff regarding billing questions, benefit details, and coverage issues.
• Maintain organized and accurate billing and insurance records in accordance with HIPAA and agency policies.
• Remain current on home health billing regulations, payer guidelines, and insurance requirements.
• Respond to incoming calls from patients, insurance providers, and clinicians, addressing questions and resolving concerns.
• Communicate with field staff regarding insurance-related questions and issues.
• Support the billing team with additional tasks and assist as needed.

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description

Requirements

Basic Qualifications

• High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
• 1-3 years of billing experience required; home health billing experience preferred, or equivalent education.
• Working knowledge of medical terminology.
• Strong written and verbal communication skills with a focus on providing excellent customer service.
• Strong attention to detail and organizational skills.
• Ability to multitask and perform effectively under pressure while managing changing priorities and short deadlines.
• Demonstrated sense of responsibility and willingness to take initiative.
• Proficiency with computers and software applications, including Microsoft Office, Excel, and SharePoint.
• Ability to maintain confidentiality and comply with HIPAA regulations.