POSITION TITLE: Claims Processing Clerk

DEPARTMENT: Patient Financial Services

REPORTS TO: Patient Financial Services Director

JOB PURPOSE: To improve the health and wellbeing of our communities.

BASIC FUNCTION: The Claims Processing Clerk serves as a member of the Patient Financial Services team. Working closely with the clinic coders, is responsible for inputting and transmitting claims, printing workers’ compensation claims, transmitting statements and charging rejections in the system.

Specific duties include following up on charged rejections in order to correct account information; processing/transmitting clinic statements and printing client bills in Allscripts system; closing out each business day in multiple systems; printing weekly rejections, printing client invoices, and printing monthly statements. Prints weekly reports including claim rejection and late charge reports for processing by department members. Enters charges, posts payments and follows up on age trial balances for both the hospital and clinics. Generates bills for various agencies. Assists in facilitating the Women’s Wellness/Komen program by posting payments, following up and distributing monthly report to appropriate parties. Uploads explanation of benefit statements from a variety of sources for electronic funds transfer payments. Serves as the contact person/site administrator for various vendors.

Reviews the Care Center for American Health Tech (AHT) items and adjusts balance as needed. Reviews the Care Center self-pay patient records monthly and adjusts statements as needed. Posts the Care Center payments in a variety of formats. Processes the Care Center month end closing including transferring claims to online drives. Balance deposits from all GRHD facilities and post clinic payments.

Clerical duties include responding to email and telephone inquiries, processing departmental mail, preparing and processing reports, scanning documents and deposits, etc. Maintains department equipment including folding machine and postage meter by installing updates and scheduling routine maintenance with vendors periodically. Performs a variety of tasks and other duties as assigned.

QUALIFICATIONS:

Education: High School Diploma or equivalent required. Associates degree in related field preferred.

Experience: Two years or relevant work experience in a similar position preferred.

SALARY INFORMATION :

$17.45 - $21.44 Dependent on Experience

BENEFITS:

We offer a wide range of best in class benefits. Grand River Hospital District benefits include: medical insurance with prescription drug coverage, vision and dental insurance, medical and dependent care flexible spending accounts, life and accidental death and dismemberment insurance, disability, employee assistant programs, paid time off to cover family illness (sick time), holidays, personal business, vacation and other activities, extended illness benefits, 457 retirement plan with match, AFLAC, identity theft protection and pet insurance.