Billing Clerk

The Billing Clerk correctly bills all claims to Commercial and Government Agencies either manually or electronically through a clearinghouse. Reviews compliance of each account billed for payer specific requirements. Works with Medical Records and other ancillary departments to obtain information requested by third party payers. Processes adjustments as requested by management in regards to observation hours greater than payer requirements.Position RequirementsGeneral billing knowledge of various insurance types along with required codes including Revenue, HCPCS, ICD-10, Occurrence, Value and Condition codes.

Knowledge of insurance regulations for government and managed care Payers.

Worker’s Compensation billing knowledge and MCO relationship with State.

Answers telephones, routes calls, takes messages, and provides routine information to callers.

Operates a calculator, copy machine, or related office machinery in performing assignments; performs light typing, etc.

Essential FunctionsReviews charges on claims and requests corrections if necessary.

Reviews if accounts need combined due to 72 hour rule, placing claims on hold until all charges and coding have been submitted.

Reviews payment information to determine timing of secondary billing or patient billing.

Processes correspondence in regards to rebills and late charge bills based on payer specific requirements.

Physical DemandsLight work: Exert up to 20lbs force occasionally; and/or up to 10lbs frequently.Educational, Licensure, & Experience RequirementsHigh school diploma or GED required.

Associate or Bachelor’s degree in Health Information Management preferred.

2 years medical billing and inpatient coding experience.

Prior experience with Medicaid and Medicare claims preferred.

Knowledge of medical terminology, basic anatomy, and physiology.

Experience with all major insurance carriers, including Medicare Part A and B, Medicaid, Management Care, Preferred Provider plans, and commercial carriers.

Keywords: Patient Service Representative, PSR, Customer Service, Customer Service Representative, Customer Support, Billing SpecialistCleveland Clinic is pleased to be an equal employment/affirmative action employer: Women/Minorities/Veterans/Individuals with Disabilities.