Hospital Insurance Claims Specialist

Memorial Healthcare; Owosso (MI); On-site; USD 40,000 - 54,000; Full time

Job summary

Memorial Healthcare is seeking a Billing Specialist to handle submission of hospital claims to insurance carriers under the supervision of the Manager of Patient Financial Services. The role emphasizes accuracy, timely filing, and collaboration with other departments to resolve coding or charge issues.

The position requires a high school diploma (medical billing coursework preferred) and experience with automated billing systems. Prior experience in hospital or physician billing is advantageous.

Qualifications

• High school diploma or equivalent required.
• Post high school courses in medical billing, medical terminology preferred.
• Word and Excel experience preferred.

Responsibilities

• Process new claims daily in billing software for submission to Third Party Insurance Carriers to include Primary, Secondary and Tertiary claims.
• Demonstrates the ability to determine correctness of charges and coding.
• Secure needed medical record documentation required by or requested by insurance companies when necessary to submit with claims.
• Work Account checks in Expanse to allow accounts to accurately produce claims.
• Use of critical thinking to ensure accurate and timely submission of claims.
• Work with other departments regarding coding or charge issues related to claims.
• Processes late charges on a daily basis and resubmits those charges to the insurance carriers.
• Process accounts that meet the combined accounts rules by payer to ensure timely billing of those accounts.
• Assist with Aging Accounts Receivable after processing of new claims in the AR bucket of 61-90 days.
• Attend or participate in webinars/seminars concerning billing and reimbursement changes.
• Work with patients when needed to obtain resolution of accounts.
• Must be able to work effectively with others and complete tasks within specified or given deadlines.
• Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.

Skills

Billing software

Attention to detail

Education

High school diploma or equivalent

Medical billing coursework preferred

Tools

Expanse

Job description

Memorial Healthcare is seeking a Billing Specialist to handle submission of hospital claims to insurance carriers under the supervision of the Manager of Patient Financial Services. The role emphasizes accuracy, timely filing, and collaboration with other departments to resolve coding or charge issues.

The position requires a high school diploma (medical billing coursework preferred) and experience with automated billing systems. Prior experience in hospital or physician billing is advantageous.