The Patient Financial Services Clerk may participate in any or all aspects of the patient processing and accounts receivable functions of the organization including billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting and credit balance resolution. The incumbent may balance monthly transactions and provide summaries to faculty and department administration. They will have detailed knowledge of the functions within the revenue cycle and how they interact in the life of a patient account.
DUTIES AND RESPONSIBILITIES
· Performs basic billing review for assigned claims.
· Performs insurance eligibility and benefits and update the claims status to correct buckets.
· Identifies problem accounts with payors; investigates and corrects errors, and follows-up on missing account information.
· Independently maintains uninsured work queue for assigned accounts.
· Follows internal policies and procedures for payment posting guidelines relating to payer fee schedule.
· Transfers bills to secondary or tertiary accounts, if applicable.
· Posts adjustment to appropriate accounts.
· Makes adjustment to either patient or practice accounts based on internal reports and/or documentation.
· Reads and understands different Explanations of Benefits.
· Keeps supervisor informed of areas of concern and problems identified.
· Accepts assignments from management and maintain open communication with their manager to resolve quality and production issues.
· Maintains strict confidentiality regarding confidential conversations, documents and files.
· Participates in educational activities and attends monthly staff meetings.
· Adheres to all HIPAA guidelines/regulations.
· Performs other duties as assigned.
§ High School diploma or GED required/Associates' degree preferred.
§ Understanding of payer EOBs/Remits.
§ Strong computer skills including Microsoft Word, Excel, and fast and accurate typing skills.
§ Experience using ICD-10, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions preferred.
KNOWLEDGE & EXPERIENCE REQUIRED BY THE POSITION
· Must demonstrate ability to work independently with minimum supervision in a team-oriented environment and interrelate well with individuals with diverse ethnic and cultural backgrounds and needs.
· Excellent oral, written and telephone communication.
· Working knowledge of rules and regulation pertaining to the FQHC guidelines.
· Ability to prioritize and manage multiple tasks with efficiency in dealing with multiple facilities.
· Ability to handle a large volume of project receiving and researching claims.
· Excellent computer skills, including Excel, Microsoft Word, etc.