Medical Billing Specialist

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Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise.

• Support rural healthcare facilities to achieve excellence and thrive in ever-changing landscapes
• Work alongside a team of dedicated and driven experts passionate about supporting rural healthcare with revenue cycle expertise
• Apply problem-solving and critical thinking skills in the development of processes and workflows, enhancing efficiency and accuracy
• Ensure facilities achieve accurate and compliant billing, providing the highest quality of care to patients and communities

• Elite and highly skilled professionals driven by delivering superior results, always striving for new levels of excellence
• Flexibility and autonomy with a company that understands the true value and benefits of work-life balance
• Personal and professional growth opportunities are encouraged
• Employee engagement is used as a valuable tool for achieving excellence

Please note: you will be redirected to our partner’s job portal to continue your application.

Title: Medical Billing Specialist

Department: Revenue Cycle

Status: Full-Time

Position Summary:

The Billing Specialist, known as Revenue Cycle Specialist II with ruralMED, will be responsible for planning, organizing and implementing the activities of charging, billing, collections and cash management functions. They will ensure maximum reimbursement for services provided by utilizing sound knowledge of insurance rules and regulations, best practice workflows, and the use of multiple software systems. Furthermore, with their advanced billing knowledge they will act as resource and mentor to other billing staff.

Compliance with rules and regulations of all applicable federal, state and local laws as well as Ovation policies is a condition of employment.

Education and/or

Experience:

High School Diploma is required.
Associates or Bachelors degree preferred.
Two (2) years of medical billing experience required, 5 years preferred.
Knowledge of medical terminology and/or insurance terminology is required.
Proficient with Microsoft Office

General Requirements/

Job Duties:

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The requirements listed below are representative of the knowledge, skill, and / or ability required:

• Responsible for the evaluation, coordination, development and implementation of billing and related processes.
• Processes electronic and paper claims in a timely and accurate manner. Ensures edits to electronic claims meet and satisfy billing compliance guidelines for electronic submission.
• Resolves clearinghouse and DDE claim errors and payer rejections.
• Performs follow-up processes on underpaid or unpaid insurance claims. Researches, identifies and rectifies any circumstances affecting delayed payment of accounts and takes steps to get claim paid utilizing websites, phone calls to the payers, and/or internal inquiry.
• Resolves issues holding up timely claim payment, including requests for medical records, coordination of benefit issues, and request for more information, by coordinating with the responsible department.
• Reviews remaining balances on accounts after insurance has paid to ensure the account was processed appropriately and performs the next appropriate action.
• Resolves overpaid accounts by performing payment review to determine if posting corrections are required or/and a refund is due to the insurance company.
• Processes incoming correspondence from insurance companies, and performs proper action utilizing internal and external resources.
• Maintains an account aging process for tracking accounts approaching 30 days past billing date.
• Processes adjustments or corrections to patient account(s) according to policy guidelines.
• Resolve denied claims utilizing…