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HomeMy WebLinkAboutMed Records/Insurance Billing Clerk . . . JEFFERSON COUNTY Job Description Job Title: Medical Records Clerk/Insurance Billing Clerk Department: Health and Human Services Reports To: Financial Manager FLSA Exempt (YIN): NO Union: UFCW 1001 BBP: NO HIPAA Rating: 2 Salary Level: Grade 21 b& Location: Castle Hill Mall .~_' tn, ~ Approved By: Human Resource Mana&,v1fiL- - Approved Date: November 2004 SUMMARY Compiles and maintains medical insurance and records; performs various computerized billing activities and various associated support functions by performing the following duties. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Maintains various computerized billing & insurance information systems. Maintains chart records, inserting diagnosis, provider notes, records data from different facilities, prescriptions, recalls, places in appropriate location in chart for easy reference, and preparation for clinics. Performs data entry for client check-in and check-out database with all information pertinent to visit including charges. Collects payments due. Schedules appointments including assigning times per provider, identifying type of appointment required, and finding appropriate time slot. Operates computers to record data and maintain records of transactions. Maintains insurance billing system to provide reports required for and from the department. Maintains vital records, insurance and service billings preparing data from charts, lab reports, and other sources. Prepares and records data from various sources that ensures billing for all services provided. Assists with compiling data from client records and preparation of reports. Backfill for reception, registration and WIC for lunch times, vacations and sick time off. Prepares insurance assignment form with data such as names of insurance company and policy holder, policy number, and physician diagnosis. Jefferson County Job Description: Medical RecordslInsurance Billing Clerk Contacts insurance company to veritY patient coverage and obtain information concerning extent of benefits. . Receives, records, and reports payments from various State and other agencies. Performs insurance billing and payment reconciliation and compiles reports Answers patients' questions regarding statements and insurance coverage. Telephones or writes companies with unpaid insurance claims to obtain settlement of claim. Responds orally and in writing to inquiries from internal departments and outside agencies. Coordinates and cooperates with outside auditors as required during periodic audits of insurance records. Performs data entry for immunization records on cards and reminds clients of additional immunization as necessary. Performs data entry for client check-in with all information pertinent to visit including charges. Schedules appointments including assigning times per provider, identifying type of appointment required, and finding appropriate time slot. SUPERVISORY RESPONSffiILlTIES . This job has no supervisory responsibilities. COMPETENCY: To perform the job successfully, an individual should demonstrate competency in the following: Cost Consciousness - Works within approved budget; Conserves organizational resources. Diversity - Demonstrates knowledge ofEEO policy; Shows respect and sensitivity for cultural differences. Ethics - Treats people with respect; Keeps commitments; inspires the trust of others; Works with integrity and ethically; Upholds organizational values. Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; supports organization's goals and values. Planning/Organizing - Prioritize and plans work activities; Uses time efficiently. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. Ouality - Demonstrates accuracy and thoroughness; Monitors own work to ensure quality. Ouantitv - Meets productivity standards; Completes work in timely manner. Safety and Security - Observes safety and security procedures; Reports potentially unsafe conditions; Uses equipment and materials properly. Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. . AttendancelPunctuality - Is consistently at work and on time; Ensures work responsibilities are Page 2 of 4 Jefferson County Job Description: Medical RecordslInsurance Billing Clerk . . . covered when absent; Arrives at meetings and appointments on time. Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Completes tasks on time or notifies appropriate person with an alternate plan. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative ofthe knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE High school diploma or general education degree (OED); and two (2) years experience in medical record keeping, billing and insurance record keeping, and/or technical training; or equivalent combination of education and experience. Bilingual English/Spanish desired. LANGUAGE SKILLS Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. MATHEMATICAL SKILLS Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. REASONING ABILITY Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. COMPUTER SKILLS: To perform this job successfully, an individual should have knowledge ofMS Access Database software; MS Explorer Internet software; MS Excel Spreadsheet software and MS WORD, word processing software. CERTIFICATES, LICENSES, REGISTRATIONS Valid Washington State Driver's License OTHER SKILLS AND ABILITIES Knowledge of computers and skill in the use of spreadsheet, database, word processing, and other software applications used in the operation of the department. Knowledge of medical terminology, legal requirements for medical records. Page 3 of 4 Jefferson County Job Description: Medical Records/Insurance Billing Clerk . . . Understands the need for maintaining confidentiality of sensitive information and has knowledge of the regulations regarding the release of medical records. PHYSICAL DEMANDS: 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee frequently is required to stand, walk, sit, and reach with hands and arms. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, depth perception, and ability to adjust focus. WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. CAREER LADDER POSITION This position is not part of a career ladder. Page40f4