Billing Clerk – Clinical Services

Job Description

A Billing Clerk – Clinical Services supports the clinical revenue cycle by processing patient and insurance billing information, maintaining accurate account records, handling related administrative duties, and coordinating with clinical and administrative staff to ensure timely and correct billing for healthcare services. This role ensures that services rendered by clinical departments are billed accurately to insurance companies and patients, and that payments are recorded appropriately.

Key Responsibilities

1. Prepare and Submit Billing Claims

• Use coded clinical data to create and submit claims to insurance companies and third‑party payers.
• Ensure claims are complete, accurate, and meet payer standards to reduce denials.

2. Verify Patient Insurance and Billing Information

• Confirm patient insurance eligibility and coverage before services are billed.
• Update patient demographic and financial information in billing systems.

3. Process Payments and Adjustments

• Track payments received from insurance and patients; apply payments to the correct accounts.
• Process billing adjustments and coordinate with collections for delinquent accounts.

4. Review and Resolve Billing Discrepancies

• Investigate and correct billing errors or inconsistencies identified in claims or payment postings.
• Follow up on unpaid or denied insurance claims and resubmit when appropriate.

5. Maintain Billing Records

• Maintain accurate and organized account records, including invoices, receipts, and billing logs.
• Ensure records comply with internal policies and healthcare regulations.

6. Data Entry and Reporting

• Enter patient, service, and insurance data into billing and accounting systems with high accuracy.
• Generate reports to support billing operations, revenue tracking, and auditing.

7. Customer Service and Communication

• Respond to internal and external inquiries related to billing statements, charges, coverage questions, or payment issues.
• Communicate with patients, clinical staff, and insurance representatives professionally and clearly.

8. Support Clinical & Administrative Teams

• Coordinate with clinical departments regarding services rendered to ensure charges are captured.
• Assist with month‑end closing functions, reconciliations, and record reviews as required.

9. Compliance and Confidentiality

• Follow HIPAA and other privacy policies when handling patient billing and insurance information.
• Adhere to healthcare billing regulations and payer guidelines throughout all processes.