We are seeking a dedicated Accounts Billing Specialist to join our team in a regional healthcare setting within the Midwest. This full-time role involves managing the submission and follow-up of insurance claims for hospital and clinic services, ensuring timely and accurate billing processes.

Key Responsibilities

• Prepare and submit clean claims electronically or by paper to various insurance companies.
• Verify all necessary information for insurance claims to ensure accuracy and timely submission.
• Collaborate with healthcare providers and departments to confirm correct charges, diagnoses, and procedures are reported.
• Follow up on unpaid claims within standard billing cycles and resolve discrepancies.
• Address patient billing inquiries and complaints with professionalism and care.
• Review insurance payments for accuracy and compliance with contracts or discounts.
• Identify and bill secondary or tertiary insurance carriers as needed.
• Manage all billing correspondence and mail promptly and appropriately.
• Investigate third-party claims and file hospital liens when necessary, including satisfaction of liens.
• Send patient letters requesting additional information for claim payments when required.
• Process late charges and refunds within established timeframes.
• Serve as the primary contact for all office billing matters, including insurance and third-party claims.
• Maintain up-to-date knowledge of Medicare, Medicaid, and other third-party payer billing requirements and changes.
• For Medicare billing, accurately process RTPs on FISS and handle secondary claims and adjustments timely.
• Run, review, and follow up on reports related to encounter forms, daily charges, receipts, insurance submissions, and accounts receivable.

Education and Experience

• High school diploma or GED equivalent is required.
• Proficiency with PC and experience in inpatient and outpatient hospital insurance claims filing and reimbursement principles is preferred.
• Ability to operate standard office equipment efficiently.

Requirements

• Completion of a Mandatory Reporter course at hire or within six months of start date.
• Compliance with all federal, state, and professional licensure and regulatory training requirements.

This position offers a warm and supportive work environment in a regional healthcare facility serving the Midwest community.