Billing Insurance Clerk
Posted on: May 15, 2022
Job DescriptionSalary: Company Overview:Pediatric Associates of
Dayton, Inc. is dedicated to providing high-quality healthcare for
infants, children, and adolescents in the Dayton area with office
locations in Beavercreek, Englewood, and Kettering. Pediatric
Associates of Dayton, Inc. is a division of CareCloud Practice
Management a subsidiary of CareCloud Inc. Job Summary:The
Billing/Insurance Clerk is responsible for insurance and billing
processing duties including verification of insurance coverage,
processing of insurance claims, processing payments received from
insurance companies, handling inquiries from patients about
insurance and their account status, and general patient counseling
on insurance questions. This position is also responsible for
providing daily medical billing collection and customer service
efforts on patient accounts, including charges and payments into
the computer system, ensuring resolution of edit reports from the
billing system, claims intermediary and third-party payers.
Essential Duties and Responsibilities:BILLING:
- Receive and verify documents required for billing and follow-up
purposes, including verification of new patient benefits,
correcting as necessary, and entering into the computer.
- Process primary, secondary, and tertiary claims according to
respective regulations and policies.
- Coordinate filing of secondary insurance.
- Correspond with third-party representatives, as necessary, to
complete claims processing and/or resolve problem claims.
- Respond to patient and third-party inquiries via the telephone
or written correspondence in a timely manner.
- Interface with other departments, when appropriate, to obtain
information necessary to process or resolve claims.
- Follow up daily on post-processing activity including, but not
limited to, rejected billings, adjustments, re-billing, and unpaid
- Request claims forms via the computer.
- Return documents in error to appropriate individuals for proper
- Work cooperatively with Front Office Staff to ensure the
collection and updating of patient demographic and fiscal
- Coordinate with medical office staff to ensure applicable
collection of co-payments and outstanding balances from patients at
the time of service.
- Post payments (insurance and self-pay) to patient
- Review and reconcile electronic payments.
- Update file maintenance as requested (referring physician,
- Make adjustments to patient accounts according to written
policies and procedures.
- Research and process complex charge corrections.
- Prioritize work received and complete in a timely
- Answer patient inquiries regarding claims on the telephone or
- Perform billing clerical duties, including review and
verification of patient account information against insurance
- Resolve routine patient billing inquires and problems. Follow
up on balances due from insurance companies, and type invoices to
- Enter data electronically to process charges, payments,
denials, and adjustments.
- Analyze and code surgical procedures and diagnoses using ICD-10
and CPT-4 codes.
- Maintain a file system necessary for proper organization of
insurance processing and follow-up of insurance.
- Perform necessary clerical work related to insurance
- Knowledge of accounts receivable practices and medical business
- Knowledge of coding and practice operating policies and
- Knowledge of insurance company reimbursement procedures and
- Skill in using computer and calculator.
- Ability to examine documents for accuracy and
- Ability to prepare records in accordance with detailed
- Ability to work effectively with co-workers as a team
- Ability to communicate clearly.Education & Experience
- High School Diploma or GED
- Three years of prior medical office experience in billing and
insurance processing or a combination of education and experience
- Experience with A4/ Allscripts/ Ntierprise preferred.Other
- Requires sitting for long periods of time while working in an
- Some bending and stretching may be required.
- Manual dexterity and normal vision for work on a calculator and
computer are required.
- The ability to work under stress is required.Supervisory
Responsibility: No Work Location: EnglewoodTravel Required: N/A
Position Type: Full-Time / Non-Exempt EEO Statement: CareCloud is
an equal employment opportunity employerPhysical Demands: 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. While performing the duties of this job, the
employee is regularly required to talk or hear. The employee
frequently is required to stand; walk; use hands to finger, handle
or feel; and reach with hands and arms. Specific vision abilities
required by this job include close vision, distance vision, color
vision, peripheral vision, depth perception, and the ability to
adjust focus. This position requires the ability to occasionally
lift office products, equipment, and supplies, up to 20 pounds.ADA
Statement: Reasonable accommodations may be made to enable
individuals with disabilities to perform essential job
functions.Other Duties: Please note this job description is not
designed to cover or contain a comprehensive listing of activities,
duties, or responsibilities thatBenefits:CareCloud recognizes the
importance of benefits and wellness for employees and their
families. In addition to time off to support work-life balance and
enjoyment, we offer a comprehensive benefits package designed for
employees' individual needs (including domestic partners).
- Healthcare – A choice of medical plans designed to meet your
- Dental & vision
- 401(K) with company match
- Flexible spending accounts (health & dependent care)
- Company-paid life insurance (accidental and supplemental
coverage at low cost)
- Company-paid Short and Long term disability
- Voluntary benefits
- Flexible PTO and Paid Holidays
Keywords: MTBC, Dayton , Billing Insurance Clerk, Accounting, Auditing , Dayton, Ohio
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