Hospital Billing Speciali - Medical Center Financial Svcs

Job Title

Hospital Billing Specialist – Medical Center Financial Services

North Oaks Health System

Full Time (Mon – Fri 8:00 a.m. – 4:30 p.m.; remote and flex schedule may apply)

Performs account follow-up and resolution of patient receivables. Works with a rotating weekend shift, ensuring timely billing, follow-up, and reimbursement to meet payer filing limits.

• Daily obtain insurance information and add appropriate carrier/plan information.
• Have working knowledge of governmental, state, and insurance billing guidelines and insurance reimbursement. Review consecutive account work queue daily to ensure billing guidelines are met and all accounts are billed and collected within the timely filing limits of each payer.
• Review, process, and maintain follow up on outstanding accounts assigned by work queue designation and/or ATB reports.
• Research and write up account adjustments on the proper adjustment form and route for the appropriate signatures of authorization, as outlined in the adjustment policy when necessary.
• Call patients to obtain financial information, insurance information, and discuss status of accounts when necessary.
• Analyze credit balance accounts in assigned work queue to process third‑party, patient refunds and correct the misapplication of funds when necessary.
• Contact Medicaid, Medicare, commercial insurances, and/or third‑party payers for status of claims on a daily basis.
• Transfer balances to patient balance daily after insurance pays, denies or when deemed appropriate.
• Request medical records when needed to process claims.
• Research and determine the necessary actions needed to resolve accounts within the designated time frame set by insurance payers.
• Research and determine the necessary actions needed to resolve denied accounts/charges for all payers listed on Explanation of Benefits and/or Remittance Advices on a daily basis.
• Check status on Medicaid, Medicare, and/or insurance accounts via various electronic systems on a daily basis.
• Document in notes all information and activities pertaining to the account on a daily basis (who, what, why, when, and where).
• Consistently maintain open communication with all hospital departments.
• Maintain confidentiality and adhere to HIPAA compliance.
• Attend in‑services and other meetings as required.
• Make efforts to achieve and exceed departmental goals on an ongoing basis.
• Maintain performance and productivity levels set within the performance indicators.
• Follow North Oaks Health System policy and procedures, compliance program and all federal and state regulatory guidelines.
• Perform other duties as assigned.

• High school graduate or equivalent.
• Hospital or professional billing experience, or completion of a Billing and Coding technical curriculum.
• Experience with financial accounting, budgeting, reporting or payroll processing can substitute for billing experience.
• Working knowledge of billing and reimbursement policies of third‑party payors.
• Data entry and computer skills; excellent written and oral communication skills.

• Strength:
  Sedentary
• Push:
  Occasionally
• Pull:
  Occasionally
• Carry:
  Occasionally
• Lift:
  Occasionally
• Sit:
  Constantly
• Stand:
  Occasionally
• Walk:
  Occasionally

Entry level

Full‑time