Day 1 as a billing clerk

Outcome

By the end of your first day you have built and submitted at least one clean claim, watched its 999 + 277CA come back, worked one denial from the worklist end-to-end, and you know where the timely-filing alert lives. Tomorrow's pace will pick up.

You are responsible for

• Building and submitting claims from VALIDATED charges.
• Working the denials worklist — reviewing CARC / RARC, deciding rebill / appeal / write-off / educate.
• Posting ERAs when they arrive (sometimes you'll share this with a posting clerk; sometimes it's all you).
• Filing appeals where indicated.
• Watching the timely-filing report so charges don't expire.

Required scopes

Scope	What it lets you do
billing.charge.read	View the charges worklist
billing.claim.read / .write	View / build / submit / reverse claims
billing.denial.read / .write	Triage denials
billing.receivable.read / .write	Post ERAs
billing.denial.appeal	File an appeal
reports.read.financial	See AR + days-in-AR widgets

If your tenant admin onboarded you as a billing clerk you already have these. If a button is greyed out, hover the badge — it tells you the scope you're missing.

Your first day, step by step

1. Sign in and skim the Dashboard. The Billing dashboard view shows AR, days-in-AR, denial trend, auto-correction success rate, and timely- filing alerts. Notice which numbers your team will care about; we'll come back to them all week.

2. Walk a clean claim end-to-end. Open /charges?status=VALIDATED, group by member, pick a single member's day of charges, click Build claim. Open the resulting /claims/:id, read the Validation tab — should be empty on a clean charge — click Submit. See 3.1 — Build & submit.

   Watch the Submission tab over the next minutes. The 999 should land within minutes. The 277CA usually lands within hours and flips the claim to ACCEPTED. See 3.2 — Track acks.

3. Open the denials worklist at /denials. Sort by age descending. Pick the top row.

   • Read the CARC + RARC. Hover the code for a tooltip; click for the reference excerpt.
   • Open the Auto-correction tab — has the engine attempted? What was the outcome?
   • Decide: auto-correct, manual rebill, appeal, write off, or route back to clinic for education.

   See 5.1 — Denials worklist and 5.3 — Auto-correction console.

4. Post an ERA, even if it's a small one. Open /receivables, pick a RECEIVED row, walk the six tabs (Auto-matched, Review, Unmatched, Exceptions, Adjustments, Trace). Confirm and post. See 4.1 — ERA inbox.

5. Bookmark the timely-filing alert. Open the Dashboard's Timely- filing alerts panel. Click the within 7 days bucket to see what is most urgent. See 6.3 — Timely-filing watch.

Quick reference for the codes you'll see

The receivables and denials pages show CARC / RARC codes constantly. Bookmark 9.3 — CARC / RARC reference; here is the day-1 cheat-sheet:

Code	Likely action
CO-1 / CO-2 / CO-3	Patient liability — auto-routed to patient AR.
CO-4	Auto-correctable (modifier injection).
CO-16	Auto-correctable (missing info).
CO-18	Duplicate — auto-detect via claim_relationship.
CO-22	Bill the right payer; a COB question.
CO-29	Timely filing — auto-correct or write off.
CO-45	Charge exceeds fee schedule — informational.
CO-50	Non-covered service — manual review.
CO-97	Bundled — auto-correct via re-coding.
CO-197	Auth missing — auto-correct attaches the auth and rebills.
PR-1 / PR-2 / PR-3	Patient deductible / coinsurance / copay.

Common Day-1 mistakes (avoid them)

Mistake	Better way
Building a claim that mixes filing types	The button greys out — don't disable the check; split the selection.
Submitting before resolving validation issues	The platform refuses; the issues panel is right there.
Manually rebilling a CO-4 the engine could auto-fix	Trust the auto-correction; check /denials/:id Auto-correction tab first.
Writing off a denial inside the appeal window	Even when you intend to write off, log a Communication note explaining why no appeal — your supervisor will use it.
Confirming auto-matched 835 lines without spot-checking totals	The platform is conservative but not perfect; spot-check.
Sending a charge back to the clinical team without a clear note	Use the Tag for education action with a one-sentence note; the team can act on it.

Your daily rhythm

• Morning:
  1. Dashboard scan.
  2. Timely-filing alerts.
  3. Top of denials worklist (sort age descending).
• Through the day:
  • Post ERAs as they arrive (the alert bell fires on RECEIVED).
  • Build & submit any newly validated charges.
• End of day:
  • Skim AR aging — anything new in the ≥60-day bucket?
  • Hand off open exceptions on receivables you couldn't close.

Where to next

• New denial to triage: 5.1 — Denials worklist.
• ERA to post: 4.1 — ERA inbox.
• Appeal to file: 5.5 — File an appeal.
• Charge stuck on NEEDS_FIX: 2.3 — Fix validation issues.