Billing Specialist I - HB | 1.0 FT

Phelps Health; Rolla (MO); On-site; USD 38,000 - 52,000; Full time

Job summary

Phelps Health in Rolla, Missouri is seeking a Billing Specialist I to manage insurance claim data entry, submission, and post-claims inquiries. You will work under the Billing Supervisor to ensure accurate, timely processing of accounts.

Key responsibilities include submitting claims electronically, resolving patient questions about balances and coverage, and following up on unpaid or denied claims while maintaining HIPAA compliance and high-quality service.

Qualifications

• High School Diploma or GED is required.
• Medical billing experience is highly preferred.
• Experience with billing software and electronic data submission is preferred.

Responsibilities

• Enter information for insurance claims and verify accuracy.
• Submit claims to clearinghouse or insurers electronically or on paper.
• Answer patient questions about copays, deductibles, and coverage.
• Follow up on unpaid or rejected claims and resubmit as needed.
• Prepare appeal letters when claims are denied and gather supporting information.
• Maintain HIPAA compliance in handling patient information.
• Assist with soft collections and notify patients as needed.
• Verify patient benefits and eligibility; process secondary claims after primary processing.

Skills

Medical billing

Customer service

Data entry

Education

High School Diploma or GED

Tools

Billing software

Job description

Phelps Health is a 2000-employee-strong hospital and healthcare system serving the heart of small-town Missouri.

No matter where you start with us, we’re committed to taking our team to the top. If you’re ready for the challenge of providing life‑saving care or supporting those who do, read on to find your fit in the Phelps Health family.

General Summary

• The Billing Specialist I is responsible for collecting and entering claims, post insurance, submit claims, and answer patient inquiries on accounts. Reports to the Billing Supervisor.

Essential Duties And Responsibilities

• Enters information necessary for insurance claims such as patient, insurance, and insurance ID. Insures claim information in complete and accurate.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form.
• Answers patient questions on patient responsible portions, copays, deductibles, write-off's, etc. resolves patient's complaints or explains why certain services are not covered.
• Follow up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany letter.
• Follows HIPAA guidelines in handling patient information.
• May perform "soft" collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
• Understand managed care authorizations and limits to coverage such as number of visits.
• Verify patient benefits eligibility and coverage as needed.
• Prepares and submits secondary claims upon processing by primary insurer.

Education

• High School Diploma or GED required.

Work Experience

• Medical billing experience highly preferred. Experience in billing software and electronic data submission preferred.

Certification/License

• Certification/License

Mental/Physical Requirements

• Ability to receive and express detailed information through oral communications, visual acuity, and the ability to read and understand written directions. Normal mental concentration with repetitive operations for a long period of time. Ability to stand, walk, sit, and reach. Occasionally lifts and transports items weighing up to ten (10) pounds. .

Working Conditions

• Standard office conditions with more than average noise. Periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases.

At Phelps Health, we think we have a better team, benefits, and opportunities for growth than anyone else around, and we invite you to see for yourself!