Biller / Insurance Clerk

Department: Business Office Position: Full Time, Non-Exempt

Brief Description of Job:
Responsible for all aspects of the Insurance Billing process, including but not limited to collecting
and entering claim information, posting insurance to patients’ accounts, managing accounts,
submitting claims, and following up with insurance carriers on unpaid or rejected claim.

Essential Functions:

Submits and monitors claims for submission to payer via claims scrubber (Relay)
electronically or paper.

Process claims.
Perform posting charges.
Achieve maximum reimbursement for services provided.
Works with appropriate department on billing questions/issues.
Submit billing data to the appropriate insurance providers.
Perform completion of claims to payers.
Follows up on submitted claims if no payments from insurance payers and works claim

denials to ensure collection of payment due to RCH.
Handles patient questions/complaints regarding their accounts; corrects errors as

appropriate or explains patient responsibility.
Supports and abides by all hospital, department, safety and National Incident

Management System policies and procedures.
Resolve denial instances.
Conduct duties in a professional and timely fashion.
Works assigned shift/shifts, weekends, and holidays, as scheduled.
Answers switchboard and other phones in the office, when needed.
Conduct patient registrations when needed.
Participate on committees as required.
Deploy, maintain, and report on various programs.

Educational/Experience Requirements:
High school diploma or equivalent is required.
A bachelor’s degree, or previous experience, in business, health care administration,

accounting or related field is preferred.
Computer Experience required; understanding of billing software and electronic

medical records preferred.
Basic math skills including calculating and monetary exchanges.
Understands HIPAA regulations and privacy of patient and employee information.