Medical Office Billing Clerk-Intermediate

Under general supervision, responsible for performing any combination of routine verifying and posting of charges for Department of Medicine specialties.  

• Detail oriented with the ability to organize, prioritize and coordinate work within schedule constraints and handle emergent requirements in a timely manner. 
• Ability to adapt to changing requirements based on work demands.
• Ability to effectively communicate orally and in writing.  
• Ability to adhere to productivity and quality standards.  
• Must provide excellent customer service and be able to work collaboratively with various staff in the immediate team and larger organization.   

EXPERIENCE:

EDUCATION:

• High school diploma or GED is required.

• Uses variety of reports and tools to identify pending charges and performs data entry functions to ensure thorough and accurate data capture.  
• Charge capture is performed using data entry tools within Epic (electronic medical record).   
• Performs basic review of medical record documentation.  
• Closely follows guidelines and protocols established for assigned work.  
• Works with diligence and attention to detail.  
• Notifies supervisor of any barriers to working efficiently and effectively.   
• Reviews claims that have been adjudicated by Medicare, Medicaid, and Commercial carriers for appropriate billing.  
• Addresses denied claims, claims pended for medical necessity, and claims pending for supporting documentation and/or medical records by working with various teams such as clinic staff, registration staff, and coding staff to complete appeals.  
• Extracts information regarding patient treatment from medical records and works closely with coding staff to compose individualized appeal letters.  
• Identifies payor specific patterns or trends regarding denials and reports to management for communication to Medical Departments and Administrators.  
• Makes the necessary recommendations regarding billing and edit creation to reduce denials.  
• Remains current in all payor specific guidelines.  
• Utilizes various collection processes such as appeals or collection notices by mail, electronic correspondence, and telephone communication with payor representatives.