Clinical Analysis Clerk - Paxton Clinic - FT

GENERAL SUMMARY

To manage the billing, coding, and collections of Medicare, Medicaid, Commercial Insurance and Private pay accounts receivable.  There will be phone, email and regular mail interaction with Third Party Payers, family members and patients who may have questions regarding account billing and/or balance. 

GIBSON AREA HOSPITAL & HEALTH SERVICES MISSION STATEMENT

To provide personalized, professional healthcare services to the residents of the communities we serve.

PRINICIPAL DUTIES AND RESPONSIBILITIES

1.    Verify codes and charges entered by providers and nurses

2.    Complete coding for any providers who do not complete their own

3.    Post co pays and money collected by the front desk to the appropriate account

4.    Post money received in the mail from statements and Insurance carriers. 

5.    Balances daily work

6.    Prepares deposits to go to the hospital

7.    Answers billing questions from patients 

8.    Communicates with co-workers in a professional manner

9.    Manages and runs a weekly unbilled report to review with managers/directors

10.    Maintains confidentiality at all times

11.    Makes arrangements with patients that have an outstanding balance to be paid in a timely fashion.

12.    Checks to make sure IPA eligibility sheets are correct for coverage of the patient

13.    Follows up on past due accounts for Insurance, Medicare, Medicaid carriers as well as Private pay patients

14.    Initiates/coordinates appeals when needed

15.    Monitor and complete credit transfers when needed

16.    Oversees communication with schedulers, staff, and providers on needed CPT code information

PHYSICAL REQUIREMENTS
1.    Physical strength to perform the following lifting demands:

•    Floor to waist - 20 pounds
•    14” to waist - 30 pounds
•    Waist to shoulder - 20 pounds
•    Shoulder to overhead - 10 pounds
•    Carry 30 pounds for 30 feet
•    Push 10 pounds/force for 15 feet
•    Pull 10 pounds/force for 15 feet

REPORTING RELATIONSHIP
Reports to the Office Manager

EDUCATION, KNOWLEDGE, AND ABILITIES REQUIRED:

1.    High school graduate or equivalent.

2.    Ability to deal with the public in a pleasing and efficient manner.

3.    Skill with computer application and other office equipment

4.    Ability to speak clearly and concisely

5.    General knowledge of mathematics and accounting principals

6.    Ability to establish and maintain effective working relationships with patients, employees, and the public

7.    Good communication skills to assist patients with billing questions and concerns

8.    Requires analytical skills to evaluate claims for errors in billing and payment from payers.

9.    Knowledge of Patient Rights.

10.    All other duties as assigned by the Office Manager/Director, Providers and/or Midlevel Practitioner.

INFECTION EXPOSURE RISK LEVEL
Category 3 – No Risk – Your job does not involve exposure to blood, body fluids or tissue.  You do not perform or help in emergency medical care or first aid as part of your job.

WORKING CONDITIONS
1.    Will work in an office with co-workers where traffic may be constant subjecting your work to interruptions, which can produce stress and fatigue.

2.    Involves frequent contact with staff, patients and the public and may involve dealing with angry or upset people.

3.    Works with an office where there are relatively few discomforts due to dust or dirt. There is some exposure to print noise.

4.    May be required to work beyond regular clinic hours.