MTBC: Billing Insurance Clerk

Company Overview:Pediatric Associates of Dayton, Inc.

is dedicated to providing high-quality healthcare for infants, children, and adolescents in the Dayton area with office locations in Beavercreek, Englewood, and Kettering.

Pediatric Associates of Dayton, Inc.

is a division of CareCloud Practice Management a subsidiary of CareCloud Inc.Job Summary:The Billing/Insurance Clerk is responsible for insurance and billing processing duties including verification of insurance coverage, processing of insurance claims, processing payments received from insurance companies, handling inquiries from patients about insurance and their account status, and general patient counseling on insurance questions.This position is also responsible for providing daily medical billing collection and customer service efforts on patient accounts, including charges and payments into the computer system, ensuring resolution of edit reports from the billing system, claims intermediary and third-party payers.Essential Duties and Responsibilities:BILLING:Receive and verify documents required for billing and follow-up purposes, including verification of new patient benefits, correcting as necessary, and entering into the computer.Process primary, secondary, and tertiary claims according to respective regulations and policies.Coordinate filing of secondary insurance.Correspond with third-party representatives, as necessary, to complete claims processing and/or resolve problem claims.Respond to patient and third-party inquiries via the telephone or written correspondence in a timely manner.Interface with other departments, when appropriate, to obtain information necessary to process or resolve claims.Follow up daily on post-processing activity including, but not limited to, rejected billings, adjustments, re-billing, and unpaid claims.Request claims forms via the computer.Return documents in error to appropriate individuals for proper completion.Work cooperatively with Front Office Staff to ensure the collection and updating of patient demographic and fiscal information.COLLECTION:Coordinate with medical office staff to ensure applicable collection of co-payments and outstanding balances from patients at the time of service.Post payments (insurance and self-pay) to patient accounts.Review and reconcile electronic payments.Update file maintenance as requested (referring physician, payor, etc.).Make adjustments to patient accounts according to written policies and procedures.Research and process complex charge corrections.Prioritize work received and complete in a timely manner.CUSTOMER SERVICE:Answer patient inquiries regarding claims on the telephone or in person.Perform billing clerical duties, including review and verification of patient account information against insurance program specifications.Resolve routine patient billing inquires and problems.

Follow up on balances due from insurance companies, and type invoices to insurance companies.Enter data electronically to process charges, payments, denials, and adjustments.Analyze and code surgical procedures and diagnoses using ICD-10 and CPT-4 codes.Maintain a file system necessary for proper organization of insurance processing and follow-up of insurance.Perform necessary clerical work related to insurance processing.Required Qualifications/Skills:Knowledge of accounts receivable practices and medical business office procedures.Knowledge of coding and practice operating policies and procedures.Knowledge of insurance company reimbursement procedures and practices.Skill in using computer and calculator.Ability to examine documents for accuracy and completeness.Ability to prepare records in accordance with detailed instructions.Ability to work effectively with co-workers as a team member.Ability to communicate clearly.Education & Experience Requirements:High School Diploma or GEDThree years of prior medical office experience in billing and insurance processing or a combination of education and experience is required.Experience with A4/ Allscripts/ Ntierprise preferred.Other Considerations:Requires sitting for long periods of time while working in an office environment.Some bending and stretching may be required.Manual dexterity and normal vision for work on a calculator and computer are required.The ability to work under stress is required.Supervisory Responsibility: NoWork Location: EnglewoodTravel Required: N/APosition Type: Full-Time / Non-ExemptEEO Statement: CareCloud is an equal employment opportunity employerPhysical 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.

While performing the duties of this job, the employee is regularly required to talk or hear.

The employee frequently is required to stand; walk; use hands tofinger, handle or feel; and reach with hands and arms.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

This position requires the ability to occasionally lift office products, equipment, and supplies, up to 20 pounds.ADA Statement: Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities thatBenefits:CareCloud recognizes the importance of benefits and wellness for employees and their families.

In addition to time off to support work-life balance and enjoyment, we offer a comprehensive benefits package designed for employees’ individual needs (including domestic partners).Healthcare – A choice of medical plans designed to meet your individual needsDental & vision401(K) with company matchFlexible spending accounts (health & dependent care)Company-paid life insurance (accidental and supplemental coverage at low cost)Company-paid Short and Long term disabilityVoluntary benefitsFlexible PTO and Paid Holidays