Medical Office Billing Clerk - Intermediate

This position is based in a high-volume call center environment and focuses on medical billing support, including handling patient inquiries, insurance questions, and account resolution over the phone.

Under general supervision, the role performs routine calculating, posting, and verifying duties to obtain primary insurance data for use in preparing statements to patients’ insurance carriers. It may also prepare notices to patients regarding amounts expected from insurance and from the patient.

The position reviews adjudicated claims from Medicare, Medicaid, and commercial carriers for appropriate billing, works denied claims and claims pended for medical necessity or supporting documentation, and collaborates with clinic staff, registration staff, and coding staff to complete appeals. It also extracts information from medical records to help compose individualized appeal letters, identifies payer-specific denial trends, and makes recommendations to reduce denials. The role remains current on payer guidelines and uses appeals, collection notices, email, and telephone communication with payer representatives.