top of page

INSURANCE ELIGIBILITY CLERK

The Insurance Eligibility Clerk reports to the Billing Manager and is responsible for meeting or exceeding the requirements and duties required of the Billing Department.  The Insurance Eligibility Clerk is responsible for providing the best customer service to their customers at all times.  The Insurance Eligibility Clerk will be responsible for making sure that all patients and staff are acknowledged, greeted, and treated in a manner that demonstrates the high level of caring, trust, and respect that is expected of all Livingston Community Health staff.

Essential Functions:

Payroll

  1. The Insurance Eligibility Clerk will be held accountable for meeting all of the requirements of the job duties as listed in this job description.
     

  2. The Insurance Eligibility Clerk will be responsible for ensuring that they always perform their job duties accurately, correctly, and in a timely manner.
     

  3. The Insurance Eligibility Clerk will be responsible for carrying out and promoting for the successful implementation of any and all policies of the clinic and the administration.
     

  4. The Insurance Eligibility Clerk is responsible for the daily preparation and entering in of the insurance data of patients that will be used in the creation of the monthly receivables accounts.
     

  5. The Insurance Eligibility Clerk is responsible for conducting and completing all necessary patient and insurance inquires prior to patient’s first visit.
     

  6. The Insurance Eligibility Clerk is responsible for completing all eligibility checks on all types of insurance at least three days prior to the patient’s visit date.
     

  7. The Insurance Eligibility Clerk will be responsible for providing each location’s receptionist with a copy of their patients spot checks, listing any information that needs to be collected, such as AOB’s, ROI’s and/or MSP’s that need signatures, updated insurance cards/information, updated driver’s license card/information, or if there is a co-pay or share of cost that needs to be collected.
     

  8. The Insurance Eligibility Clerk will be responsible for providing patients information and answers in regards to any of their billing questions.
     

  9. The Insurance Eligibility Clerk must be able to accurately enter data.
     

  10. The Insurance Eligibility Clerk must learn all of the intricacies of the insurance plans utilized by our customers.
     

  11. The Insurance Eligibility Clerk must be able to examine, verify, and complete all forms required for the billing process.
     

  12. The Insurance Eligibility Clerk must be able to QC encounter forms for accuracy.
     

  13. The Insurance Eligibility Clerk must keep providers and any other staff who have a need to know, up to date on all billing standards requirements related to any programs our patients utilize.
     

  14. The Insurance Eligibility Clerk is responsible for acknowledging all patients in a timely, friendly, and respectful manner whether they are in person or on the phone.
     

  15. The Insurance Eligibility Clerk must be able to foster relationships with area personnel that encourage teamwork and team building.
     

  16. The Insurance Eligibility Clerk will make sure that all phone calls are answered and addressed in a prompt manner.  No one should be on hold for any significant length of time.
     

  17. The Insurance Eligibility Clerk will work 8 hours per day, 5 days per week.  Any deviation from this schedule requires the approval of their Supervisor.

Competencies

  1. Communication
     

  2. Consultation
     

  3. Critical Evaluation
     

  4. Ethical Practice
     

  5. Global & Cultural Awareness
     

  6. Organization

Required Education and Experience

  1. High School Diploma or GED required.
     

  2. Must have 2 to 5 years’ experience as a health care clinical biller, medical receptionist or similar type work.
     

  3. Working knowledge of MS Word, Excel and PMS.
     

  4. Must be familiar with medical terminology
     

  5. Preference given for applicants that are familiar with ICD-10 and CPT medical coding.
     

  6. Must know 10 key by touch.
     

  7. Must possess excellent customer service skills.
     

  8. Must be able to perform basic mathematical functions.
     

  9. Must have good writing skills.
     

  10. Must be able to foster departmental and interdepartmental relationships.
     

  11. Must be able to quickly think and assess situations correctly.
     

  12. Must be able to provide training to staff as needed.

Supervisory Responsibilities

Work Environment:

This position has no direct supervisory responsibilities.

​This job operates in a professional office environment. This role routinely communicates verbally and on a face to face basis with others.

Typical Physical Demands:

Requires standing and walking for up to eight hours at a time. Some bending, stretching, or reaching may be necessary. Lifting up to 40 pounds maybe required on occasion. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contact.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for their job. Duties, responsibilities, and activities may change at any time with or without notice.

bottom of page