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Insurance Clerk

Company: Thurmond Eye Associates, P.A.
Location: Weslaco
Posted on: May 3, 2021

Job Description:

Job Responsibilities

  1. The Insurance Clerk I is responsible for filing all insurance claims accurately and in a timely manner as to insure proper payment of claims.
  2. The Insurance Clerk will monitor all delinquent claims and will resubmit claims accurately and in a timely manner.
  3. This individual will work closely with the Billing & Coding Manager to maximize reimbursements to the Clinic by solving problems as they arise.
  4. They must possess knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.

Education and Experience

  1. High School or Equivalent


  1. Customer Service
  2. English and Spanish Languages
  3. Computers and Electronics

Physical Requirements:

  1. Sitting for long periods of time
  2. Requires repetitive movement

Job Duties

  1. Requires being exact or highly accurate.
  2. Requires meeting strict deadlines.
  3. File Medicare/Medicaid insurance claim forms.
  4. Follow up on unpaid claims.
  5. Appeal Medicare/Medicaid denials for clinic and optical as well as typing out MRANS for crossovers, redeterminations forms, and send any necessary attachments.
  6. Answer telephone calls and correspondence pertaining to insurance.
  7. Speaking to patients and explaining their insurance coverage and balance.
  8. Assist patients by answering their questions regarding Medicare allowable and adjustments.
  9. Print out itemized statements or send copies of charge tickets to patients.
  10. Fill out application and fax invoices for payment for Lions Club patients as well as helping patients apply for other type of assistance.
  11. Update insurance information with Medicaid TPR Department.
  12. Update Medicare and Medicaid yearly fee schedules and quarterly drug fee schedules as well as keeping staff informed of any guideline changes.
  13. Bill skilled nursing facilities for patients who have tests done in the office.
  14. Checking and printing out eligibility forms through Tex Med when requested.
  15. Keep informed on all current third party payer policies and procedures, especially Medicare and Medicaid coding changes.
  16. Answer telephones and schedule appointments as needed.
  17. Effectively communicate with supervisor and administrative staff.
  18. Ability to make decisions that affect other people and or/the image and reputation of the practice.
  19. Adhere to company policies and protocol.
  20. Any other duties that may be required.

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Keywords: Thurmond Eye Associates, P.A., Edinburg , Insurance Clerk, Other , Weslaco, Texas

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