Clerk - Insurance

Paycom - ATS; Dothan (AL); On-site; USD 17,000 - 25,000; Full time

Job summary

SpectraCare is seeking an Insurance Clerk to work in the Administration Office in Dothan. The role involves filing private insurance and billing agency fees for services across divisions, with a focus on Medicare Part B, Medicaid, and related contracts.

Essential duties include timely electronic filing of claims, prompt follow-up with carriers, and maintaining compliance with applicable regulations. The position requires accuracy, confidentiality, and ability to handle overtime or weekend shifts

Qualifications

• Experience handling medical insurance claims and billing workflows.
• Knowledge of Medicare Part B and Medicaid billing requirements.

Responsibilities

• File insurance claims electronically and ensure timely submission.
• Follow up on unpaid claims to secure payment within 120 days.
• Maintain Medicare/Medicaid billing guidelines and related documentation.
• Assist with adjustments on consumer accounts and EOPs as needed.
• Protect confidentiality per HIPAA and SpectraCare policies.
• Attend required meetings and training and adhere to dress code.

Skills

Billing software

Medicare/Medicaid knowledge

HIPAA compliance

Excel

Word

Accounting software

HRIS systems

Communication

Education

High School Diploma/GED

Tools

Emdeon Claim Filing

Web-based interfaces

Job description

Insurance ClerkThe Insurance Clerk will work out of our Administration Office in Dothan. This position will be responsible for filing all private assigned insurance and billing agency fees for services contracts applicable to each division of SpectraCare.Working hours for this position will be Monday - Thursday 7am-430pm and Friday 7am-11am.POSITION SUMMARY/FUNCTIONFile all private assigned insurance on behalf of consumers. Bill all agency fee for service contracts available for consumers that are applicable to each division of SpectraCare. All billing will be accomplished by the most efficient and effective methods approved by SpectraCare. Accounts Receivables for each reimbursement source will be maintained at a level of less than 120 days.ESSENTIAL DUTIES/RESPONSIBLITIES/FUNCTIONS/TASKS:1. Timely filing (electronically) of insurance claims.2. Timely unpaid claim follow-up with carriers, agencies, and Medical Records to ensure payment within 120 days.3. Assist other Business Office staff with EOPs and necessary adjustments on consumer accounts.4. Maintain current manuals and billing requirements for Medicare Part B, Medicaid Rehabilitative Service Contract and Physician Medicaid.5. Assist SpectraCare staff with third party reimbursement information.6. Regular attendance with timely arrival and departure according to scheduled hours.Must be able to work full time with rotating assignments as necessary to include but not limited to overtime hours, nights, and/or weekends as scheduled.To ensure client/employee safety while on duty, must remain awake during scheduled working hours.7. Communicate with all billing staff within the Insurance Department as a team member.8. Performs other duties as directed including but not limited to the following.Treat others with respect and courtesy at all times.Ensure necessary documentation is completed in a timely manner with minimal errors and in compliance with applicable guidelines and policies.Receive and respond to inquiries of insurance matters promptly and courteously.Meet with supervisor as established.Follow guidelines of SpectraCare Personnel Policy, SpectraCare Clinical Policy, including but not limited to the Alabama Administrative Code, CMS, and all other applicable regulating and contractual entities.Participate in training, workshops, in-services, and/or administrative meetings as assigned.Ensure any necessary documentation is completed and up to date before annual leave or personal leave is taken.Adhere to Dress Code as set forth in the SpectraCare policies and procedures.Respond to emergency and/or crisis situations as they arise.Functions and performs well in stressful environments and manages work related stress to ensure the safety of others.Demonstrates a willingness to work on any unit / program at SpectraCare based on facility needs as directed.Ability to conform to SpectraCare’s Core Values as duties are carried out daily.Functions within professional boundaries with individuals and others.Works in a cooperative manner with other SpectraCare employees, individuals, and/or family members.Performs duties independently and/or with minimal supervision.Perform all duties with the highest standard of ethics.Works well with other staff and individuals to ensure safety of program, individuals and other staff.Other services, tasks, functions, and responsibilities deemed necessary; not otherwise specified.NON-ESSENTIAL DUTIES/RESPONSIBLITIES/FUNCTIONS/TASKS:Attend departmental meetings and other assigned meetings.Attend all required job-related/system training.Assist in other areas needed.Conforms to system’s policies and procedures.ESSENTIAL QUALIFICATIONS/KNOWLEDGE/SKILLS/ABILITIES:Administrative ability, consistent with qualifications below, requiring minimal supervision and direction.Ability to use and understand billing software and billing websites.Ability to interpret and understand Medicare, Medicaid and other third party claim filing requirements and coding requirements.Position has access to a large amount of sensitive information concerning SpectraCare operations and consumers, thus the utmost discretion is required. Confidentiality must be maintained under SpectraCare policy and procedure, HIPAA law and 42 CFR.Knowledge of computerized information systems used in financial and/or accounting applications.Ability to make minor decisions in accordance with rules and regulations and apply these to work problems.Ability to have patience and emotional stability.Must perform all duties with the highest standard of ethics.Ability to communicate with staff and others, in a professional manner, both written and oral.Working knowledge of business English, spelling and arithmetic.Working knowledge of office practices and procedures.Ability to operate office machines such as computer, fax machine, and copy machine.Ability to read instruction manuals printed in English.Ability to understand and follow moderately complex oral and written instructions.Ability to perform a wide variety of job tasks, in a safe manner without endangering any employee, client, or asset.Ability to operate and follow through with assignments with minimal supervision. Must be motivated and able to make quick and accurate decisions. Must be able to meet and exceed expectations. Must be able to perform all duties with minimum mistakes.Ability to work overtime, as needed, and travel locally. Must have valid driver’s license.Ability to make minor decisions in accordance with rules and regulations and apply these to work problems.Ability to follow orders and directives and work with supervisor and other staff.Skill in typing rapidly and accurately.Ability to maintain unit files through computer software programs to include but not limited to Excel, Word, Accounting Software, HRIS programs, etc.Ability to maintain departmental clerical records and prepare reports from such records.Ability to make arithmetic computations and tabulations accurately and with reasonable speed.Ability to adhere to health and safety standards.Ability to stay awake during working shift.Ability to demonstrate initiative.Ability to travel as necessary.Ability to function and perform well in stressful environments and manage work related stress to ensure safety of others.Ability to pass a drug screen when given to include but not limited to pre-employment, random, post-accident, suspicion, etc.Ability to get along with others and function within professional boundaries with individuals and others.Ability to adapt to conditions which may vary considerably.Ability to establish effective working relationships with the public, other staff, Program Director and all levels of organizational staff.ESSENTIAL TRAINING REQUIREMENTS:Complete initial new hire training.Complete required on the job training (OJT) training by the department.Obtain proper certifications needed to perform job duties.Complete annual training as required by the Alabama Administrative Code, CMS, and all other applicable regulating and contractual entities.WORK ENVIRONNMENT / PHYSICAL REQUIREMENTS:Physical ability to work assigned shift. May require periodic overtime work to meet the organizations’ needs.Work location is primarily in a temperature-controlled office with extended periods of computer use at a desk with associated repetitive motions. Must understand and practice good ergonomic movements to avoid injuries.Job requires occasional use of office equipment and ability to correctly lift up to twenty (20) pounds on an infrequent basis.Job requires occasional and limited bending, twisting and reaching.Required to talk to or hear staff, clients, and/or others.The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.REQUIRED QUALIFICATIONS/EDUCATION/EXPERIENCE:High School Diploma/GED with no less than three years of secretarial/general office experience.Must have valid driver’s license.Experience in with web-based interfaces.1 year experience filing medical insurance claims.PREFERRED QUALIFICATIONS/EDUCATION/EXPERIENCE:3 years experience filing medical insurance.Experience with Emdeon Claim Filing