Billing Clerk

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Job description

The Billing Clerk correctly bills all claims to Commercial and Government Agencies either manually or electronically through a clearinghouse. Reviews compliance of each account billed for payer specific requirements. Works with Medical Records and other ancillary departments to obtain information requested by third party payers. Processes adjustments as requested by management in regards to observation hours greater than payer requirements.

Position Requirements

* General billing knowledge of various insurance types along with required codes including Revenue, HCPCS, ICD-10, Occurrence, Value and Condition codes.
* Knowledge of insurance regulations for government and managed care Payers.
* Worker's Compensation billing knowledge and MCO relationship with State.
* Answers telephones, routes calls, takes messages, and provides routine information to callers.
* Operates a calculator, copy machine, or related office machinery in performing assignments; performs light typing, etc.

Essential Functions

* Reviews charges on claims and requests corrections if necessary.
* Reviews if accounts need combined due to 72 hour rule, placing claims on hold until all charges and coding have been submitted.
* Reviews payment information to determine timing of secondary billing or patient billing.
* Processes correspondence in regards to rebills and late charge bills based on payer specific requirements.

Physical Demands

Light work: Exert up to 20lbs force occasionally; and/or up to 10lbs frequently.

Educational, Licensure, & Experience Requirements

* High school diploma or GED required.
* Associate or Bachelor's degree in Health Information Management preferred.
* 2 years medical billing and inpatient coding experience.
* Prior experience with Medicaid and Medicare claims preferred.
* Knowledge of medical terminology, basic anatomy, and physiology.
* Experience with all major insurance carriers, including Medicare Part A and B, Medicaid, Management Care, Preferred Provider plans, and commercial carriers.

Keywords: Patient Service Representative, PSR, Customer Service, Customer Service Representative, Customer Support, Billing Specialist

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after 90 days.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

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