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Solano County · 2 months ago

Primary Insurance Billing Clerk

Aiken, SC

Full-time

Onsite

Senior Level

5+ years exp

Solano County is seeking a Primary Insurance Billing Clerk who will be responsible for the primary billing of all ambulance claims. The role involves reviewing Emergency Medical Services claims for accuracy, submitting bills to the appropriate insurance carriers, and providing customer service to patients and insurers.

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Responsibilities

Billing – Following the claims review, the incumbent prepares and mails all bills to the correct insurance carrier for payment. The incumbent is actively involved in attempting to get reimbursements for the County from EMS patients. In doing so, the incumbent will conduct training for EMS on medical coding to increase accuracy of patient records and reporting for reimbursement

Customer Service – This position interfaces regularly with patients and insurance carriers to answer any questions or concerns. The incumbent is responsible for providing EMS reports showing errors and calculations of missed revenue on a monthly basis

The incumbent must be confident with using different insurance tools to verify patients’ eligibility and be able to submit claims in a timely manner to insurance to ensure payment for emergency services provided

In the fulfillment of these responsibilities, the incumbent will interface daily with co-workers and the management team of EMS. The incumbent interacts daily with both County employees for problem solving, and with citizens to answer questions

The incumbent works within rather well-defined parameters for health care insurance reimbursement practices and procedures. Any exceptions to these rules must be reviewed by the Finance Director and the EMS Director. Any approvals for write-offs must be made by the Finance Director

Challenges to this position include dealing with patients who are sick, unable to think clearly, and unable to understand the reimbursement process with the insurance companies. Further, the insurance companies do not always communicate the changes in their health plan coverages