Accounts Receivable/Billing Clerk
Valley HealthCare System, Morgantown, WV, United States
Accounts Receivable/Billing Clerk
Morgantown Office - Morgantown, WV 26508
Overview
Position Type Full Time Job Shift Day Education Level High School Diploma
Description
JOB TITLE: Accounts Receivable/Billing Clerk Revised: May 2024
DIVISION: Administration/Accounting & Finance
REPORTS TO: Revenue Cycle Manager
FLSA STATUS: Non-Exempt
WORK HOURS: Monday through Friday, Various
NATURE OF WORK: Responsible for workflow and communication with programs on documentation corrections. Responsible for reports notifying programs and management the status of documentation. Responsible for scanning all paper documentation including downloading & maintaining all paper and electronic remittance & payment source documents/files. Responsible for reviewing remittances and documenting claims issues into program management system and notifying biller of denial or processing error. Assist billers in researching, submission of denied claims for Medicaid, MCO, invoice claims and occasionally TPL denials. Assists in research to resolve partial payments and unapplied cash on client accounts. Reads and comprehends instructions and informs Revenue Cycle Manager of necessary issues for claim submission and resolution. Possesses the interpersonal skills necessary to interact with consumers and Valley staff, including managers, to resolve any billing questions/issues. Presents and projects a professional, business-like image to consumers and Valley staff.
ESSENTIAL DUTIES:
Ability to batch and apply all cash receipts
Accurately post payments into database both manually and electronically
Audits and reviews payments for accuracy and compliance
Reviews unapplied/unidentified payment issues to assure timely posting to client accounts.
Reviews private pay & completes any refunds notifies Revenue Cycle Manager of any billing issues
Responds to customer inquiries and requests that may require extracting and analyzing system data
Informs appropriate personnel of billing and/or procedural issues.
Establish and maint
Aain constructive working relationships with coworkers, supervisors, managers, as well as external clients and other external business contacts.
Supports and assists in training of new employees.
Uses the program management system to generate reports and transfer data from system to Microsoft Excel to format into easily readable format for programs/management and to research as directed.
Assures all request for service corrections are reviewed/completed within business day submitted and communicates status to necessary parties.
Assures the workflow for service correction is followed depending where in the cycle the service is in the billing cycle; unbilled in open accounting period, claimed, paid or in a closed accounting period.
Confirms Census is verified then compiles and post daily room & board charges and saves all generated reports to folder following workflow procedure.
Scans all paper documentation and saves to the correct folder with naming convention procedures.
Maintains and files all paper documentation in the correct file cabinet/folder and attached to the correct paper claim.
Download and maintain all electronic remittance, 835payment, 270/271, 277 & 999 files to the correct folder and naming procedure.
Confirms 835, 270/271, 277 & 999 file is uploaded into Avatar and reviewed for acceptance, rejections, errors and proceeds to research, correct or inform responsible staff or department of the error.
Reviews all paper and electronic remittance for denials or communications from guarantor adjudication and records the denial in program management system using the appropriate form(s).
Informs the biller or other responsible department(s) of the denial or partial denial or communications from the guarantor.
Reviews billing/payment activity on consumer accounts for accuracy and makes necessary corrections as directed.
Primary staff to answer phone calls, emails concerning any financial account questions from clients, staff and/or physicians.
Effectively and professionally resolves issues with clients and insurance payers.
Monitors, maintains and uses appropriately, all equipment and supplies
OTHER DUTIES AS ASSIGNED
Qualifications
MINIMUM QUALIFICATIONS: ______________________________________________________________________________
Ability to perform essential duties as outlined below
High school Diploma or Equivalent
Communications skills; read, speak and write the English language proficiently
Active Listening skill
Intermediate computer skills
Intermediate knowledge of Microsoft Excel, Word and Outlook
Basic knowledge operating normal office equipment
Ability to comprehend moderately complex instructions
Ability to Multi-Task
Attention to Detail
Ability to work in a team
Demonstrate problem solving
Comply with Client's Rights.
Comply with Valley's and Division departmental safety procedures
Qualities of Reliability, Self-Motivation and Positive Attitude
PREFERRED QUALIFICATIONS: ____________________________________________________________________________
Knowledge of medical terminology; CPT, ICD-10 and HCPCS
Knowledge of health care insurance claim practices and compliance
Knowledge of WV Medicaid policies and third party billing practices
Previous experience working in medical office
Previous experience in medical billing
Possess basic knowledge of accounting practices
Morgantown Office - Morgantown, WV 26508
Overview
Position Type Full Time Job Shift Day Education Level High School Diploma
Description
JOB TITLE: Accounts Receivable/Billing Clerk Revised: May 2024
DIVISION: Administration/Accounting & Finance
REPORTS TO: Revenue Cycle Manager
FLSA STATUS: Non-Exempt
WORK HOURS: Monday through Friday, Various
NATURE OF WORK: Responsible for workflow and communication with programs on documentation corrections. Responsible for reports notifying programs and management the status of documentation. Responsible for scanning all paper documentation including downloading & maintaining all paper and electronic remittance & payment source documents/files. Responsible for reviewing remittances and documenting claims issues into program management system and notifying biller of denial or processing error. Assist billers in researching, submission of denied claims for Medicaid, MCO, invoice claims and occasionally TPL denials. Assists in research to resolve partial payments and unapplied cash on client accounts. Reads and comprehends instructions and informs Revenue Cycle Manager of necessary issues for claim submission and resolution. Possesses the interpersonal skills necessary to interact with consumers and Valley staff, including managers, to resolve any billing questions/issues. Presents and projects a professional, business-like image to consumers and Valley staff.
ESSENTIAL DUTIES:
Ability to batch and apply all cash receipts
Accurately post payments into database both manually and electronically
Audits and reviews payments for accuracy and compliance
Reviews unapplied/unidentified payment issues to assure timely posting to client accounts.
Reviews private pay & completes any refunds notifies Revenue Cycle Manager of any billing issues
Responds to customer inquiries and requests that may require extracting and analyzing system data
Informs appropriate personnel of billing and/or procedural issues.
Establish and maint
Aain constructive working relationships with coworkers, supervisors, managers, as well as external clients and other external business contacts.
Supports and assists in training of new employees.
Uses the program management system to generate reports and transfer data from system to Microsoft Excel to format into easily readable format for programs/management and to research as directed.
Assures all request for service corrections are reviewed/completed within business day submitted and communicates status to necessary parties.
Assures the workflow for service correction is followed depending where in the cycle the service is in the billing cycle; unbilled in open accounting period, claimed, paid or in a closed accounting period.
Confirms Census is verified then compiles and post daily room & board charges and saves all generated reports to folder following workflow procedure.
Scans all paper documentation and saves to the correct folder with naming convention procedures.
Maintains and files all paper documentation in the correct file cabinet/folder and attached to the correct paper claim.
Download and maintain all electronic remittance, 835payment, 270/271, 277 & 999 files to the correct folder and naming procedure.
Confirms 835, 270/271, 277 & 999 file is uploaded into Avatar and reviewed for acceptance, rejections, errors and proceeds to research, correct or inform responsible staff or department of the error.
Reviews all paper and electronic remittance for denials or communications from guarantor adjudication and records the denial in program management system using the appropriate form(s).
Informs the biller or other responsible department(s) of the denial or partial denial or communications from the guarantor.
Reviews billing/payment activity on consumer accounts for accuracy and makes necessary corrections as directed.
Primary staff to answer phone calls, emails concerning any financial account questions from clients, staff and/or physicians.
Effectively and professionally resolves issues with clients and insurance payers.
Monitors, maintains and uses appropriately, all equipment and supplies
OTHER DUTIES AS ASSIGNED
Qualifications
MINIMUM QUALIFICATIONS: ______________________________________________________________________________
Ability to perform essential duties as outlined below
High school Diploma or Equivalent
Communications skills; read, speak and write the English language proficiently
Active Listening skill
Intermediate computer skills
Intermediate knowledge of Microsoft Excel, Word and Outlook
Basic knowledge operating normal office equipment
Ability to comprehend moderately complex instructions
Ability to Multi-Task
Attention to Detail
Ability to work in a team
Demonstrate problem solving
Comply with Client's Rights.
Comply with Valley's and Division departmental safety procedures
Qualities of Reliability, Self-Motivation and Positive Attitude
PREFERRED QUALIFICATIONS: ____________________________________________________________________________
Knowledge of medical terminology; CPT, ICD-10 and HCPCS
Knowledge of health care insurance claim practices and compliance
Knowledge of WV Medicaid policies and third party billing practices
Previous experience working in medical office
Previous experience in medical billing
Possess basic knowledge of accounting practices