Join to apply for the Insurance Clerk role at Westchester Medical Center Health Network.
Distinguishing Features of the Class:
- Under general supervision, an Insurance Clerk processes insurance claims to third-party health carriers for billing medical services provided to patients at Westchester Medical Center.
- Responsibilities include initial billing, investigation and reconciliation of problem claims, maintaining automated accounts, filing, and other clerical tasks.
- Supervision is not a responsibility of this class.
Examples of Work:
- Prepares and submits claims to third-party payors to obtain reimbursement for patient care.
- Enters and reconciles billing and payment data on an automated system to maintain and update receivable status of patient accounts.
- Makes inquiries of medical records and admitting staff for clarification of diagnosis, insurance coverage, or other details necessary for completing forms and maintaining records.
- Interacts with the Admitting Office, Business Office, or Medical Records Department to provide updated billing information.
- Communicates with carriers and other third-party payors by correspondence or telephone to determine proper billing and receivable status.
- Maintains and updates files and patient records with pertinent billing information.
- Works with Credit and Collection staff to ensure reimbursement from third-party payers.
- Reconciles balances for bookkeeping purposes and transmits data for further processing.
- Maintains complete files of billing accounts including medical diagnosis and other necessary information.
- Handles routine billing inquiries from patients, third-party payors, and hospital staff.
Required Knowledge, Skills, Abilities, and Attributes:
- Good knowledge of hospital billing procedures and familiarity with processing procedures involved in health and hospital insurance.
- Familiarity with medical terminology and hospital organization functions.
- Effective oral and written communication skills.
- Ability to perform mathematical calculations using a computer.
- Proficiency with computer applications such as spreadsheets, word processing, email, and databases.
- Ability to read, write, speak, understand, and communicate in English sufficiently.
- Initiative, tact, good judgment, and physical condition suitable for the position.
Minimum Acceptable Training and Experience:
- High school diploma or equivalency and four years of clerical experience, including at least one year of processing patient medical insurance claims.
Substitutions:
- 30 college credits may substitute for experience at a rate of 30 credits per year.
Note: Education beyond secondary level must be from an accredited institution.
Additional Details:
- Seniority level: Entry level
- Employment type: Full-time
- Job function: Administrative
- Industries: Hospitals and Healthcare
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