Medical Billing Clerk - Hamakua Health Center : Job Details

SUMMARY DESCRIPTIONThe Medical Billing Clerk is responsible for ensuring timely completion of all billing functions. This position is also responsible for the data entry and maintenance of all patient accounts and recording of payments. This individual must demonstrate a clear understanding of computers and all facets of medical billing. The Medical Billing Clerk will work closely with Front Office Staff and interface with Billing Manager and Chief Financial Officer regarding specific execution of assigned duties.REPRESENTATIVE DUTIESThe following duties are typical for the Medical Billing Clerk. Incumbents may not perform all of the listed duties and/or may be required to perform additional or different duties from those set forth below to address business needs and changing business practices.

• Demonstrate positive interpersonal relations in dealing with physicians, patients, patient families, visitors, co-workers, in a professional and confidential manner.
• Embrace the philosophy of continuous quality improvement.
• Embrace and project the values of HKH: personal accountability, integrity, fairness, consistency and respect.
• Demonstrate the ability to maintain confidentiality and to protect personal health information.
• Demonstrate outstanding customer service skills consistently.
• Demonstrate the ability to work and interact as a team member.
• Apply problem solving and conflict resolution skills where needed.
• Demonstrate culturally competent patient centered care.

EDUCATION, EXPERIENCE & QUALIFICATION GUIDELINESAny combination of education and experience that would likely provide the required knowledge and abilities is qualifying.

• High School Graduate or GED equivalent
• Demonstrated proficiency with basic computer systems
• Demonstrated proficiency in operation of multi-line phone systems
• Demonstrated ability to work effectively as a team member
• Demonstrated ability working effectively with electronic and paper medical records
• Demonstrated ability working with volume mailings
• Valid Hawaii Driver's License
• Clean driving abstract
• Knowledge of basic accounting
• Familiar with basic Medical terminology.
• Proficient data entry and typing skills.
• Knowledge of Microsoft Office programs, including email.
• Excellent written and oral communication skills.
• Ability to interact appropriately and effectively with a wide variety of ages and cultures.
• Ability to provide consistent excellent customer service skills to internal and external customers
• Demonstrated excellent teamwork capabilities.
• Demonstrated organizational capabilities.
• Ability to multi-task effectively and calmly.
• Understand basic patient flow within the clinic.
• Demonstrated aptitude and ability to learn multiple processes.

Performance Requirements

• Courteous, honest and professional at all times.
• Able to communicate and relate well with physicians, clinical support staff and other HKH employees.
• Able to provide innovative input into the development of the clinic and its processes.
• Maintains appropriate licensure and certification including meeting and/or exceeding continuing education requirements where applicable.
• Efficient, organized and accurate.
• Responsible for the full range of third party and patient billing duties.
• Ensures timely input of patient billing data into the computer system with limited or no errors, utilizing Billing Reports to provide ongoing Quality Improvement
• Accurately maintains all patient accounts and record of payments.
• Ensures proper billing of patient charges to various payers.
• Possesses a clear understanding and detailed knowledge of different types of insurances, their respective billing requirements, and knowledge of how Payers submit payments to the Health Center.
• Demonstrates detailed knowledge of State and Federal rules and regulations related to billing Insurance Claims.
• Demonstrates detailed knowledge in self-pay, sliding fee collections.
• Demonstrates detailed knowledge of Medicare/Medicaid requirements and HMO/PPO contracts
• Demonstrates detailed knowledge of handling principles and various billing documents and claim forms.
• Responsible to work system generated claims, edits, attaches records, and all system reports.
• Assists Billing Manager in reviewing procedure codes annually.
• Appropriately responds to billing inquiries from patients, insurance companies and departments within the Health Center
• Appropriately identifies and resolves issues regarding account adjustments, re-billing insurance, and/or collecting from patients as appropriate.
• Demonstrates detailed knowledge of Medical insurance terminology, referrals, authorizations and pre-certification used by third party payers
• Review aged A/R monthly on a regularly scheduled basis and appropriately route claims requiring special attention.
• Maintains an accurate system of follow up on all activities that require special attention.
• Identifies issues affecting reimbursement and cash collections and communicate issues in a timely manner to Billing Manager or CFO
• Responsible for preparation for end closing and the generation of month end reports as assigned.
• Responsible for collections of delinquent accounts.
• Accurately maintains record of all collections and related activities.
• Responsible for Insurance and patient Refunds.
• Assists with cross-training of billing staff as assigned.
• Consistently maintains a clean and organized work area.
• All other duties as assigned.

PHYSICAL DEMANDS AND WORKING ENVIRONMENTThe conditions herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.Working Conditions: Environment: Work is performed primarily in a standard office environment with extensive employee and public contact and frequent interruptions. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.Physical: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Primary functions require sufficient physical ability and mobility to work in an office setting; to stand or sit for prolonged periods of time; to occasionally stoop, bend, kneel, crouch, reach, and twist; to lift, carry, push, and/or pull light to moderate amounts of weight; to operate office equipment requiring repetitive hand movement and fine coordination including use of a computer keyboard. Vision: See in the normal visual range with or without correction. Hearing: Hear in the normal audio range with or without correction.Work Schedule: This is a non exempt position. The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to successfully perform the job. Confidentiality: As an employee of Hamakua-Kohala Health Clinic, you are bound by principles of medical ethics. You have both a legal and moral obligation to protect the privacy of our patients. In the course of your work, you will have access to confidential information regarding patients, and/or the practices' confidential business. It is essential that you refrain from any discussions regarding personal information about a patient, a patient's condition, a patient's finances, proprietary company information, personnel salaries, and/or the practices' confidential business with any third person. This includes, but is not limited to, other employees, your spouse, family or friends. CONFIDENTIALITY IS SO IMPORTANT THAT ANY BREACH OF THIS POLICY WILL BE CONSIDERED GROUNDS FOR TERMINATION. Review and signature of the Agreement is a condition of employment. EEO STATEMENTHamakua-Kohala Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Hamakua-Kohala Health complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.Hamakua-Kohala Health expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Hamakua-Kohala Health's employees to perform their job duties may result in discipline up to and including discharge.OTHER DUTIESPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.