Insurance Billing Specialist

Shenandoah Medical Center; Shenandoah (IA); On-site; USD 40,000 - 52,000; Full time

Job summary

Shenandoah Medical Center in Shenandoah, IA seeks a billing specialist to review and submit clean claims, work with payers on denials, and ensure timely follow-up. You will manage aging accounts and support patient billing through EMR and clearinghouse systems.

Experience in medical office billing is preferred. High school diploma required; equal opportunity employer policy is included in the posting.

Qualifications

• High School diploma or better.
• Medical office experience preferred.
• Insurance/billing experience preferred.
• Equal Opportunity Employer and rights notice included.

Responsibilities

• Review and submit clean claims through clearinghouse and EMR.
• Follow up on accounts to meet weekly goals and resolve denials.
• Review aging reports and perform frequent follow up on aged balances.
• Perform other duties as assigned and complete training.

Skills

Medical billing

Claim processing

Denials management

Aging accounts

Education

High School diploma

Tools

EMR software

Clearinghouse

Job description

1. Review and submit clean claim for payment

• Reviews and corrects all claim edits in the clearinghouse.
• Reviews and corrects all edits within the EMR software.
• Ensure proper secondary billing.
• Review and submit Paper claims with required attachments if appropriate.
• Verifies all unknown information with the appropriate department.
• Review and correct all Medicare claim edits for submission to WPS.
• Review and correct all Return to Provider claims.

3. Completes Timely Follow-Up.

• Reviews account balances to ensure accuracy.
• Achieves department weekly goal for follow-up.
• Works with payers on denials with processes including, but not limited to, phone call verifications, medical records submission, reconsideration and appeals.
• Ensures the proper and timely submission of patient responsibility to statement vendor.

4. Completes Regular Review of Aging.

• Reviews aging reports on a regular basis.
• Completes frequent follow up on aged accounts.
• Reports issues to direct supervisor.

5. Performs other duties as assigned.

• Submission of reconsideration and appeals for payer denials as required.
• Completes and passed all training and exams.

Qualifications

Education

Required

High School or better.

Experience

Preferred

Medical Office experience preferred

Insurance/Billing experience preferred

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.