Billing/EPM Training Clerk
Eisner Health is seeking a Billing/EPM Training Clerk to join our professional team. The Billing Clerk will Processes the billing charges for services provided by medical practioners on a daily basis. The Clerk will be responsible for billing daily clean claims to payers via electronic or hard copy submission in a timely and accurate manner in keeping with department and billing standards. Bills a variety of payers ie; Medi-Cal, CHDP, Medicare, and private insurances. Reconciles encounters against the daily appointment report and identifies any and all missing charges, and begins the process of reconciliation to identify the encounters with missing charges, and makes providers aware when encounters are incomplete or missing for them to correct or complete. Follows up on unpaid claims within 30 days of claims submission. Is up to date with industry billing standards and policies. This position requires the full understanding and active participation in fulfilling the mission of Eisner Health.
- Daily key punching into computer when needed to assure accuracy of billing for all services rendered in patients account
- Reconciles encounters/superbills against kept appointments report to ensure that every visit is accounted for and billed
- Required to review each claim daily to ensure that all insurance requirements are accurate before submission to minimize denials and to ensure prompt reimbursement, if information is incomplete biller should return to appropriate supervisor in department for corrections and inform billing department lead
- Ensure completion of documentation in EMR when needed on charges entered in patient’s accounts for a correct and complete billing claim.
- Monthly input of all ancillary services to include Health Education Services encounters into the computer to assure accuracy of services rendered.
- Daily review of all charges entered
- Processes 3rd party billing within 48 hours of visit. Notifies the department lead when billing is not within this time frame to
- Is up to date on billing policies for Medi-Cal, Medicare and private payers
- Makes claim follow up calls to Medi-Cal, CHDP and/or other insurance company to get status of unpaid claims.
- Reviews accounts receivable ageing on a monthly basis to determine accounts that are outstanding and to determine where to emphasize collection efforts
- Required to review each denial that is received, makes every effort to get claims paid, maintains timeliness and resubmission deadlines, maintains unpaid claims spreadsheet with follow up and collection notes
- Meets with the Revenue Manager to discuss any denials, adjustments and write offs that are necessary
- Assess plan and develop training for staff based on needs assessments.
- Trains staff on EPM processes – registration, sliding fees, insurance verification and scanning documents.
- Other duties as assigned
- Must have knowledge of medical terminology, CPT, ICD8, and HCPCS codes.
- Minimum 2 years experience in effectively billing for various funded programs such as Medi-Cal, CHDP, and Family PACT required.
- Strong time management skills with the ability to meet deadlines and goals.
- Ability to multi task and work in a fast-paced environment.
- Must be willing to work in a team environment.
- Must type 45 words per minute.
- Proficiency in MS Office applications.
- High School Diploma or GED.
- FQHC experience a plus.