Patient Accounts Clerk

Gaston County Government; North Carolina; On-site; USD 28,000 - 33,000; Full time

Job summary

The Gaston County Public Health Department is hiring a Billing Specialist to manage patient claim billing and collection across Medicaid, Medicare, and third-party payers using the department's EHR and practice management systems.

The role requires a High School Diploma and medical billing/data entry experience; a criminal background check and drug screening are required prior to employment. Candidates must be able to work accurately in a collaborative environment.

Qualifications

• High School Diploma is required.
• Experience with medical billing and data entry in EHR/Practice Management systems.
• Knowledge of payer rules, Medicaid/Medicare, and 837/835 processes.
• Ability to work with minimal supervision and accuracy.

Responsibilities

• Bill and collect patient claims using EHR and electronic/manual systems.
• Process 837 billing and 835 posting, update clinical fee schedules.
• Follow up on outstanding claims and resubmit charges.
• Reconcile accounts after payments and denials.
• Assist with audits and respond to payer questions.
• Support quality improvement and health equity initiatives.

Skills

Medical billing

Data entry

Accounts receivable

Customer service

Education

High School Diploma

Job description

The Gaston County Public Health Department is committed to protecting, promoting and preserving the health and well-being of all Gaston County residents.

The anticipated hiring range for this position is $20.43 - 24.26

The duties listed below are not all of the duties that may be assigned but are those that are considered as essential for an employee to perform.

• Responsible for billing and collection of all patient claims for services provided, through our EHR and various electronic systems and/or manual processes for Medicaid, Medicare, Third Party payer sources and self-pay accounts. Review systems for patient demographics, financial updates, and e-bill entry prior to file submission to ensure accuracy for billing.
• Duties to include billing and posting activities: all payers, electronic and manual, primarily, but not limited to 837 billing and 835 posting files; patient statement activities; debt setoff files for reporting to the state and posting payments;updating clinical fee schedules as it relates to patient account activites; back up for billing and posting related duties as needed.
• Maintains follow-up on outstanding and/or un-paid claims billed to self-pays and Third Party payers, ie: Medicaid, insurance, Medicare; determines problem and solution through review and research and resubmits the charges for payment.
• Reconciles patient accounts after payments, denials, and/or claim determinations have been made; manual and/or electronic patient account adjustments completed; maintains files for or assists in preparation for audit of accounts. Resolves inquiries or questions from patients and insurance carriers about billing or collection issues, coding updates, non-covered charges or other related matters.
• Responsible for maintaining updated information and resources for payer source billing requirements and guidelines, to ensure services are properly billed and collection received for revenues due.
• Special projects; other duties as assigned; assist in preparedness and emergency response activities in situations that threaten the public's health (i.e. disease outbreaks, natural disasters, etc.).
• Carryout Quality Improvement (QI) roles and responsibilities, including identifying and communicating performance improvement opportunities and adjusting performance and practice to achieve established QI goals.
• Implement strategies aimed at achieving Health Equity, including but not limited to: attending trainings to better understand inequities, identifying and addressing barriers to health, serving on the Health Equity Team or its subcommittees, engaging in internal or external efforts to eliminate health disparities.

• High School Diploma
• Medical billing experience and/or data entry for physician medical practice using updated Electronic Health Record and Practice Management systems.
• Valid driver's license

The applicant selected must undergo a criminal background check and pass a drug screening test prior to employment.