HealthSource Saginaw (HSS) is looking for a Billing Clerk in our Patient Accounting Department who is passionate about the work they do and who enjoy working in a fast paced, employee centered environment. You will be challenged by the dynamic environment, where you will work as a pivotal member of the staff, to exceed company goals and foster teamwork. As an HSS employee, you will become part of our team of outstanding people working together to improve the physical and emotional health of the lives we touch each and every day.
HSS provides tuition assistance and a comprehensive benefit package including paid time off, major medical, prescription, vision, dental, defined contribution plan with up to 7% employer match, health reimbursement account, flex-spending account, employer paid life insurance and short and long term disability. HSS is a qualifying employer for the Public Service Loan Forgiveness (PSLF) program.
Pre-employment physical, drug screen and background check required. HealthSource Saginaw is an EEO/Affirmative Action employer for all including Women, Minorities, Veterans and Individuals with disabilities.
Requirements
- Minimum of a High School diploma or equivalent.
- Basic knowledge of accounting principles and medical terminology generally acquired through 6 to 12 months of college/business curriculum.
- Minimum of one year prior experience in a hospital, Long Term Care, or physician’s office billing department preferred.
- Familiarity with applicable regulatory agency requirements, such as The Joint Commission, Michigan Mental Health Code, Center for Medicare and Medicaid Services, and Community Mental Health agencies is preferred.
Summary
- Verifies, monitors, and corrects third party payer documentation received with regards to benefits, eligibility and limitations. Analyzes admitting information, gathers all appropriate data and inputs into computer system. Monitors data necessary for re-billing, including, but not limited to:
- Research rejection problems
- Notifies interdepartmental personnel for additional medical documentation, recognizes medical terminology, diagnosis and computer codes
- Collects and disseminates the data for re-billing
- Reviews Aged A/R and Unbilled Reports monthly and rebills accounts as necessary
- Verifies and reviews the computer generated billing reports.
- Documents number of approved days and authorization numbers mandatory for payment.
- Processes billings for all inpatient, outpatient, and discharged patients.
- Performs billing duties for with all insurance carriers.
- Bills both facility and professional claims.
- Reviews and enters patient pay amounts.
- Verifies eligibility with Insurance carriers.
- Updates patient's accounts when insurance coverage changes occur during billing cycle and reports insurance limitations, cancellations, or exhaustion to Patient Accounting Supervisor and applicable departments.
- Analyzes and interprets inpatient and outpatient payment vouchers for payments, pends, and rejections. Resubmits corrected billing within required time limits and notifies the Patient Accounting Supervisor of any trends in rejections, denials, or underpayments.
- Reviews insurance payment vouchers for correct reimbursement amounts. Allowances the difference between billed amount and contractual/negotiated payments received.
- Enters insurance, patient information, billings and determines patient benefits and eligibility.
- Communicates on a daily basis with third party payers, patients and/or responsible parties, and other facility departments in regards to billing problems/inquiries.
- Compliance with mandatory overtime required when necessary.
- Prepares and tracks insurance Appeals
