Billing Charge Entry Clerk

Position Summary

The Billing Charge Entry Clerkis responsible for the accurate and timely entry of charges, preparation of claims, and support of daily billing operations to ensure efficient reimbursement processes. This role reviews encounter and coding information, submits claims to payers, and assists with resolving billing discrepancies to promote clean claim submission and minimize delays in payment.

The position operates in both billing and registration capacities. Depending on operational needs, incumbents may be assigned to support multiple departments and/or clinic locations, including floating at least one (1) day per week or as otherwise required.

Essential Functions

Billing Duties

• Perform daily charge entry to ensure accurate and timely posting of patient encounters and services.
• Prepare and submit billing charges to insurance carriers and other third-party payers in accordance with established timelines.
• Follow up on delinquent claims
• Using coded dates to produce claims to insurance companies
• Verify patients' insurance coverage
• Answer patients' billing questions
• Perform posting charges and completion of claims to payers on time
• Works with third party insurances to obtain maximum level of cash to reduce receivable.
• Ensures correct processing of outstanding insurance claims by:
  • Interpreting insurance payer responses
  • Requesting account level adjust
  • Submitting appeals and claims reconsiderations
  • Evaluating financial responsibility of patients
  • Resolving insurance denials and claim rejection
  • Performing insurance verification

Patient Access Representative Duties

• Serve as a welcoming first point of contact by greeting patients in person and by phone, addressing questions and concerns with professionalism, courtesy, and compassion.
• Accurately collect, enter, and update patient demographic, insurance, and scheduling information in the electronic health record
• Schedule, reschedule, and confirm appointments including follow-ups, call-ins, and walk-ins as well as provide reminder calls to support patient engagement and reduce missed visits.
• Maintain provider schedules and distribute daily schedules to providers and clinical support staff to promote efficient clinic flow.
• Assist patients with general insurance, billing, or process questions and connect them with the appropriate team member for additional support when needed.
• Maintain registration materials and supplies and ensure the front-office area remains clean, organized, and welcoming.
• Communicate clearly, calmly, and accurately when documenting or relaying information received by phone or in person.
• Contribute to a collaborative team environment and perform other related duties as assigned to support high-quality care and operations.

Coordination and Operational Support

• Float to departments and/or clinic sites, as needed, to provide front desk coverage at least one day per week or as assigned.
• Communicate effectively with patients, providers, and staff to resolve scheduling or access issues.
• Support scheduling initiatives, reporting needs, and workflow improvements as assigned.

Core Responsibilities and Organizational Expectations

In addition to role responsibilities, every employee has the following responsibilities as a part of their employment:

• Provides courteous, responsive, and service-oriented support to patients, visitors, and colleagues. Promotes a respectful and welcoming environment, communicates clearly, and works collaboratively to support team and organizational goals.
• Performs all duties in a manner consistent with Park West Health System's mission, vision, and organizational values, demonstrating a commitment to quality care, respect, and service excellence.
• Adheres to all applicable federal, state, and local regulations, as well as organizational policies and procedures, including HIPAA, privacy, and security standards.
• Follows all infection control, workplace safety, and risk management protocols. Participates in quality improvement and performance initiatives as appropriate to the role.
• Maintains professionalism, reliability, and accountability in attendance, performance, and communication; completes required trainings; participates in staff meetings and organizational initiatives
• Performs other duties on an as-needed basis.

Qualifications

• High School Diploma or GED required.
• Associate degree in Healthcare Administration, Medical Billing and Coding, Business Administration, or a related field preferred.
• Minimum one (1) to three (3) years of experience in medical billing, charge entry, revenue cycle management, patient registration, or a related healthcare administrative role preferred.
• Experience working with electronic health records (EHR) and practice management systems required.
• Experience with Medicaid, Medicare, commercial insurance plans, and managed care billing preferred.

Skills

• Knowledge of healthcare reimbursement methodologies, claims processing, denials management, and appeals procedures.
• Experience verifying insurance eligibility, benefits, authorizations, and patient financial responsibility.
• Familiarity with medical terminology, coding concepts, and healthcare billing regulations.
• Proficiency in Microsoft Office Suite, particularly Excel, Word, and Outlook.
• Strong data entry skills with a high degree of accuracy and attention to detail.
• Ability to interpret Explanation of Benefits (EOBs), Remittance Advice (RA), and payer correspondence.
• Excellent organizational and time-management skills with the ability to manage multiple priorities and meet deadlines.
• Strong customer service skills with the ability to communicate professionally and effectively with patients, providers, insurance representatives, and coworkers.
• Ability to maintain confidentiality and handle sensitive patient information in compliance with HIPAA regulations.
• Ability to work collaboratively in a team-oriented environment while also functioning independently with minimal supervision.