Medical Billing Clerk is responsible for reviewing, researching, coding, and generating third party billing for a medical facility. Completes and verifies ICD-10 coding. Being a Medical Billing Clerk inputs and maintains all payment records in database or systems. Performs basic customer service for routine patient or other inquiries. Additionally, Medical Billing Clerk requires a high school diploma. Typically reports to a supervisor or manager. The Medical Billing Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Maintains current and up-to-date patients’ addresses and Insurance information to avoid loss of claims. Verifies prescription insurance information. Reviews all prescriptions for accuracy in data entry.
Monitors and reviews all electronic claims for accuracy in billing and submission. Ensures payment is received for all claims submitted. Reviews and corrects rejected claims. Reviews and reprocesses denied claims. Takes the appropriate action necessary to follow up and resolve rejected or denied claims. Works with insurances companies or patients to resolve rejections and denials. Submits a daily report to the Pharmacist-In-Charge for all outcomes of rejected and denied claims. Works alongside the PIC to establish guidance for the pharmacy staff on correct billing and resolving denied or rejected claims. Maintains a good working relationship with pharmacy staff. Assists pharmacy staff with data entry and billing as needed. Performs other duties as required.
Minimum 2 years of experience with billing health insurances. Pharmacy experiences preferred. Ability to effectively communicate in English, both verbally and in writing skills. Proficiency with Microsoft office (Word, Excel).
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