Definition:

The Medical Billing Clerk is responsible for the appropriate billing and coding of assigned accounts. Responsible for claim submission, insurance follow-up, denial management, deductible management, timely filing and incoming calls from patients and insurance payors.

Specific Duties: (some duties may vary depending on PreBill or PostBill job position)

• Responsible for coding ambulance, wheelchair or stretcher transports.


• Utilize and assign appropriate ICD10, HCPCS and modifiers for ambulance services to each claim.


• Read and comprehend the content of the patient care report to sufficiently analyze and perform coding to each claim.


• Submit claims for reimbursement to insurance carriers.


• Follow up on unpaid claims and initiate claim status inquiries with insurance payers.


• Work claims and claim denials to ensure maximum reimbursement for services provided.


• Work with patients to develop self-pay arrangements.


• Work timely filing and deductible management queues.


• Meet standard productivity standards.


• Demonstrate knowledge, understanding and compliance of company policies and procedures.


• Demonstrate complete knowledge of proper billing and coding procedures


• Demonstrate knowledge and understanding of (and compliance with) Federal, State and local laws, rules, regulations, and guidelines as they pertain to reimbursement, collections, and compliance.


• Work as a team member.


• Complete and maintain appropriate training, certification and licensure for their position.


• Maintain a high level of professionalism and customer service when dealing with patients, patient families, co-workers, clients, other healthcare providers and the general public.


• Notify Billing Supervisor of any lapses in documentation resulting in less than full compliance with compliance and HIPAA standards.


• Maintain security and privacy of all company and patient information at all times in accordance with HIPAA and all other local, state and federal regulations.


• Notifies Billing Supervisor of any questions, concerns or issues regarding billing, collections or compliance matters.


• Perform other duties related to billing/coding and account management as directed or needed.