Insurance Clerk
DuBois Regional Medical Center - DuBois, PA

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The best of modern health care technology, plus the best of small town America!

Located in the midst of the beautiful rolling hills and woodlands of Pennsylvania, you don't have to be a native to feel at home here. No matter where your roots, you'll quickly recognize that the staff at DuBois Regional Medical Center (DRMC), like other residents of the community, will make you feel right at home.

DuBois Regional Medical Center (DRMC) offers residents of west central Pennsylvania a rare combination of technologically advanced health care in a warm, friendly environment. Widely recognized as one of the leading health centers of its kind in the commonwealth, DRMC is an oasis of clinical and technical excellence, with a focus on patient-centered care. Its rural setting is just far enough from the hustle of the city life to make it peaceful, but close enough to provide easy access to sought-after urban attractions.

THE INSURANCE CLERK PREPARES BILLING FOR ASSIGNED INSURANCE TYPES RELATED TO INPATIENT AND/OR OUTPATIENT CLAIMS AS WELL AS ENSURES RESOLUTION OF ASSIGNED ACCOUNTS WITHIN AN ESTABLISHED TIME FRAME

Responsibilities:

* Complies with DRMC polices and procedures, with accreditation agency requirements, federal, state, or local law and regulations.
  • Submits insurance claims to third party payers for services received.
  • Investigates accounts receivable. Investigations include a systematic follow-thru, including written requests, oral communications, and until payment is received, and completing statistical coding.
  • Reviews account information for accuracy, initiates corrections and follow ups with appropriate ancillary department
  • Verifies insurance coverage procedures per department {i.e. Obtains effective date of coverage, deductibles, percentage of coverage, extent of non-covered services, second surgical opinion}
  • Monitors and responds to relevant reports {i.e. aged-trial balance, late charge, charge master, outpatient visit, cash sheets, remittance, credit report, failed claims, claims generated, and failed billing requirement}
  • Reviews explanation of benefits for accuracy, communicates with Utilization Review coordinators regularly
  • Presents patients with account information and explains the incumbent details.
  • Assists supervisors with special projects and suggests improvements for improving productivity, efficiency, and effectiveness.
  • General duties as dictated
Qualifications:
  • High school graduate or equivalent required.
  • One year in hospital billing or business field preferred.
  • Computer skills required.
  • Effective communcation skills required.
  • Ability to reason, analytical required.

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