Insurance Claims Clerk

Watertown - South Dakota (SD),

Prairie Lakes Healthcare System

Job Description:

POSITION: Insurance Claims Clerk

STATUS: Full-Time/1.0

POSITION SUMMARY: Performs the submission and follow-up of insurance claims for all service lines. Ensures billing procedures are followed to maximize cash and minimize accounts receivable.

RESPONSIBILITIES: Completes all edits to ensure claim submissions are compliant with federal and state regulations. Performs follow-up on insurance claims to obtain maximum payment in a timely manner. Administers timely and accurate billing and payment of all service lines

Processes all secondary claims to seek reimbursement following primary insurance payment. Researches and resolves requests from insurance companies, patients, and third party payors. Resolves billing problems and assists

interdepartmentally with billing issues. Assists co-workers with problem resolution and team projects to decrease accounts receivable. Works with the patient account specialists on private pay accounts. Assists patients with insurance related questions and problems.

Completes monthly billing of reoccurring accounts ((i.e. kidney dialysis, radiation, chemotherapy, home health, hospice, and physician). Other duties may be assigned.

Education and/or Experience: High school diploma or general education degree (GED); or equivalent combination of education and experience. One year prior medical or general office experience preferred. Previous billing and computer experience desirable.

CONTACT: [email protected]


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