Billing Clerk

ORGANIZATION

The mission of Ravenswood Family Health Network (RFHN) is to improve the health of the community by providing culturally sensitive, integrated primary and preventative health care to all, regardless of ability to pay or immigration status, and collaborating with community partners to address the social determinants of health.

POSITION SUMMARY

Responsible for the preparation and submission of billing for all payors including self-pay patients, public programs, and private third-party insurance. Conducts accounts receivable review and follow-up on all unpaid accounts to ensure prompt payment and performs other duties as required.

The Billing Clerk I is distinguished from the Billing Clerk II, in that the Billing Clerk I is an entry level training position. There are no requirements of previous experience in addition to the minimum qualifications of one year of billing experience in a healthcare organization. The Billing Clerk II, however, requires at least three years prior experience as a biller or billing specialist in a dentist's office or community clinic with progressively increased responsibilities in addition to the minimum requirements.

DUTIES AND RESPONSIBILITIES

To be performed in accordance with RFHN Policies and Procedures

• Reviews encounter forms for accuracy and completeness (dx codes/CDT codes/ to ensure that the encounter is accurate and billable. Returns incomplete encounters to the provider for correction.
• Reviews batches of charges entered for errors prior to posting.
• Processes billing for services to all payors including submission of electronic claims for public programs, hard copy claims on HCFA 1500's and UB 92's for private insurance, and hard copy statements for self-pay patients.
• Maintains all backup of original documentation including encounter forms, copies of hardcopy statements, and correspondence available for audit, upon request.
• Receives remittance advices for third party billing, sends check to accounting for deposit, reconciles remittance advices and posts payments in a timely manner to ensure cash flow.
• Researches denials, unpaid or partially paid claims, and rebills daily to insure prompt payment.
• Follows up one outstanding patient balances for any retro rebilling and calls patients to collect if no insurance available.
• Attends training seminars sponsored by the State or other payers to keep up-to-date on billing and eligibility issues.
• Maintains all billing manuals up-to-date by deleting outdated information and inserted new advice notices as they arrive.
• Handles calls regarding patient accounts and billing questions.
• Develops payment agreements with patients with the approval of the Director of Billing Cycle. Uses templates and work-flow documentation tools effectively to ensure that encounters are completely documented as well as enabling the collection of data for statistical reports.