Billing Clerk

WMCHealth; Village of Suffern (NY); On-site; USD 40,000 - 55,000; Full time

Job summary

A leading healthcare provider is seeking a Billing Clerk to manage billing processes, interact with patients, and ensure accurate financial records. The ideal candidate will have experience in medical billing, strong numerical skills, and a commitment to confidentiality. Join a dedicated team in a dynamic healthcare environment where your contributions will directly impact patient care and financial operations.

Qualifications

• Minimum two years of experience in medical billing and customer service.
• Knowledge of Medicare, Medicaid, and third-party billing regulations.

Responsibilities

• Maintain financial accounts on automated systems.
• Investigate and resolve account discrepancies.
• Perform cash posting duties and maintain records.

Skills

Customer Service

Numerical Skills

Computer Proficiency

Education

High School Diploma

Tools

McKesson

E-Paces

Job description

The Billing Clerk acts as the liaison between the billing department and clinic patients. Collect all necessary billing information, verify insurance, obtain signatures on appropriate forms, and enter this information into the hospital computer system. Sets fees for co-payment and self-pay patients.

Responsibilities:

1. Maintain financial accounts on automated systems.
2. Serve as liaison with Admitting Office, Business Office, and Medical Records to provide and obtain updated billing information.
3. Respond to inquiries from patients, families, departmental staff, insurance representatives, and third-party payers via written communication or telephone.
4. Correct and analyze electronic denials, suspended, and rejected claims from Medicaid or third-party payers.
5. Investigate and resolve account discrepancies; determine potential insurance or patient refunds.
6. Follow up on denials with additional information; rebill or adjust claims as necessary.
7. Perform cash posting duties; post vouchers from various insurance companies; identify and correct errors; verify postings upon receipt of cash.
8. Photocopy and refer denials for follow-up.
9. Photocopy and mail Explanation of Benefits forms to patients with co-pays.
10. Review reports for delinquent accounts over 180 days; follow up by re-billing or making account adjustments.
11. Utilize specialized software, including uploading data into McKesson for cash posting and E-Paces for Medicaid.
12. Balance checks and receipts related to Medicaid spend-down.
13. Maintain electronic and manual records of payments from patients.
14. Prepare cash and checks for deposit; maintain deposit records.
15. Maintain confidentiality of patient information.
16. Use automated systems effectively to complete work assignments.
17. Perform additional duties as assigned.

Qualifications / Requirements:

• Minimum two years of experience in medical billing and customer service within a healthcare setting, including use of medical billing software.
• Experience researching patient accounts and reconciling accounts receivable issues with the finance department.
• Knowledge of Medicare, Medicaid, and third-party billing regulations; acute care setting experience preferred.
• Strong numerical skills and computer proficiency.
• Ability to interact effectively with the public.
• Team player attitude.

Education:

High school diploma or equivalent required.

Other:

If applicable, the individual may encounter human blood or other potentially infectious materials and must adhere to universal precautions, use personal protective equipment, and follow infection control policies.