OverviewUnder direction, performs a variety of tasks related to the processing of health insurance claims. This includes examining, verifying, and computing billing data to ensure the accurate submission of insurance claims and patient invoices. The role supports the financial operations of a healthcare facility by ensuring timely and compliant reimbursement from insurers and patients.Business Title: Medical Billing ClerkCivil Service Title: Clerk 1Responsibilities:
- Reviews medical related records to ascertain type and name of company or government agency providing part or all of coverage.
- Records necessary identification data such as policy number, name of policyholder, and physician's name on forms, and obtains signatures so that claim may be submitted to proper carrier.
- Contacts insurance company or government carrier to verify information such as coverage and extent of benefits or, in the case of unpaid claims, to obtain settlement of claims.
- Computes charges to be paid by insurance company or patient.
- Completes form outlining expenses for financing company or agency to give details of bills for specific patients.
- May refer unpaid bills to another unit so that proper action can be taken, or responsible party/patient can be contacted.
- Performs other clerical work of a general nature such as receiving and sorting mail, filing, searching files and other information sources, composing correspondence, and sending form letters, answering telephone inquiries, and so forth.
- Collects information for various source documents to prepare reports.
- Adheres to strict deadlines for claim processing and submission.
- Will be required to learn to utilize various types of systems and software applications.
- May assist with other department functions and duties at any time, as assigned.
Qualifications:
- High School Diploma required, related certificate or degree desired
- Two (2) years of experience in work involving the determination of insurance, welfare, or social service benefits or services.
- Prior billing experience in a medical setting strongly preferred.
- Languages: Bilingual Spanish would be a plus.
- Knowledge of office methods, practices, routines, and equipment as they relate to clerical processing of health insurance claims forms and bills.
- Knowledge of basic arithmetic.
- Knowledge of medical and insurance terminology.
- Ability to compute billing accounts and to use an adding or calculating machine.
- Ability to communicate verbally and in writing when exchanging information with patients and insurance company representatives.
- Ability to carry out procedures according to established standards.
- Ability to work independently, to locate errors, and to resolve discrepancies.
- Ability to read, write, speak, understand, and communicate in English sufficiently to perform duties of this position.
- Must satisfy employer paid physical, drug screen and criminal background check.
- NJ residency required by State Statute. R.S.52:14-7.
The anticipated starting base pay for this position is:
- $42,000-$50,000 per year, depending on experience and qualifications.
Benefits: You can build your own future while helping to build the future of your community. With competitive benefits, including a pension plan, on-site wellness coaches, and health and dental insurance, Middlesex County offers the support employees need. The County also promotes a healthy work-life balance with generous vacation, sick, and holiday leave.