Insurance Billing Specialist

Singing River Health System; United States; On-site; USD 40,000 - 60,000; Full time

Job summary

Singing River Health System is seeking an Insurance Billing Specialist to submit hospital claims to multiple payers and manage documentation for accurate billing. The role requires resolving claim edits and performing follow-ups on denials and collections in a busy Revenue Cycle environment.

The ideal candidate has at least two years in patient accounting or insurance, with knowledge of diagnosis and procedure codes and payer reporting.

Qualifications

• High school diploma required; coursework in business or accounting preferred.
• Minimum of two years’ experience in patient accounting, insurance, or a business office.
• Experience with diagnosis codes, procedure codes, CPT, and payer reporting codes is preferred.

Responsibilities

• Submit hospital claims to multiple third-party payers including managed care, Medicare, and Medicaid.
• Coordinate collection of documentation required for accurate, compliant billing and resolve claim edits.
• Perform follow-up on re-billing, denials, adjustments, and overdue accounts per revenue cycle practices.
• Identify process improvements to billing, forms, and requirements; communicate findings to departments and management.

Skills

Communication skills

Attention to detail

Multitasking

Education

High school diploma

Business/accounting coursework preferred

Tools

MS Outlook

MS Word

Job description

Shift & Location

Shift: Monday - Thursday (9 hours) and Friday (4 hours) or Monday - Friday (8 hours)

Location: Singing River Pascagoula Hospital

Position Overview

The Insurance Billing Specialist submits hospital claims to multiple third-party payers including, but not limited to: Managed Care plans; Medicare and Medicaid; hospice and other specialty claims. He/She coordinates accumulation and verification of all necessary documentation required for billing and resolves claim level edits and errors as appropriate for accurate, compliant billing. The Insurance Billing Specialist performs follow up duties associated with re-billing, claim level denials, adjustments and collections of all overdue accounts in accordance with best business practices. He/She identifies problems and solutions or enhancements to resolve billing issues, including, billing frequency, required forms, and general billing requirements. The Insurance Billing Specialist communicates issues and offers suggestions to service line departments and management to improve processes within the Revenue Cycle.

DISCLAIMER: This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this intends to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks performed as assigned.

Education & Experience

Education: High school graduate or equivalent required. Courses in business, accounting, or related fields preferred.

License: N/A

Certifications: N/A

Experience: A minimum of two (2) years’ experience in patient accounting, insurance or a business office required. Experience with diagnosis codes, procedure and CPT codes, NCCI edits, modifiers, and standard payer reported code sets preferred.

Reporting & Supervision

Reports to: Billing Manager

Supervises: None

Physical Demands

Work is moderately active: involves sitting with frequent requirements to move about the office, move about the facility, and to travel to another facility within the SRHS service area. Work involves exerting a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. Work involves using many physical motions in performing daily work activities; subject to exposure of body fluids, sputum and tissues, which may carry the hazard of infectious disease. Work involves using repetitive motions: substantial movements of the wrists, hands, and or fingers while operating standard office equipment such as computer keyboard. Work involves being able to perceive the nature of sound at normal speaking levels with or without correction; the ability to make fine discriminations in sound. Work requires close visual and acuity and the ability to adjust the eye to bring an object into sharp focus, i.e. shift gaze from viewing a computer monitor to forms/printed material that are closer to compare data at close vision. Must be able to be active for extended periods of time without experiencing undue fatigue. Must be able to work schedules assigned with the understanding that changes may be instituted according to the needs of the hospital for off days, shifts or weekends.

Mental Demands

Must demonstrate keen mental faculties/assessment and decision making abilities. Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone. Must demonstrate strong written and verbal communication skills. Must possess emotional stability conducive to dealing with high stress levels. Must demonstrate ability to work under pressure and meet deadlines. Attention to detail and the ability to multi-task in complex situations is required. Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations.

Special Demands

Must possess superior customer service skills and professional etiquette. Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.), MS Outlook and Word. Must be able to demonstrate appropriate clinical judgment and apply appropriate professional skills to a patient population of all ages.

Company Culture

If you’re looking for purpose, teamwork, and a place where what you do truly matters, you’ve found it. Let’s do big things together.

Singing River is both a mission-driven healthcare provider and one of the largest employers on the Mississippi Gulf Coast. We offer best-of-industry benefits, scheduling options, and professional pathways for our employees. Within each of our three hospitals and 50+ primary care and specialty clinics, you'll find a team devoted to quality, teamwork, and service.