Job Description

Job Description

Job Description

Looking for Medical Billing Specialists - pay $15.98 - $20/hr
Full time - direct hire (not contract)
REMOTE- Must live in Idaho

Are you looking for a REMOTE position that offers flexibility , professional growth, and the chance to make a real impact in healthcare? As a Billing Specialist with our team, you’ll have the opportunity to work 100% remotely— if you’re based in Idaho —while playing a vital role in optimizing revenue cycle performance. You’ll help ensure accurate billing, minimize denials, and work closely with insurance providers and patients to improve our financial processes. If you're detail-oriented, experienced in billing, and excited about working in a fast-paced, rewarding environment, this is the perfect opportunity for you!

• Education: High School Diploma or equivalent required; additional healthcare or billing certifications are a plus.
• Experience:
  • Minimum 1 year of experience in billing within a hospital or clinic setting.
  • Familiarity with CPT, ICD-9/ICD-10 codes, and revenue codes.
  • Experience with UB and HCFA billing forms.
  • Prior experience with Critical Access Hospitals (CAH) or Rural Health Clinics is a plus.
  • Knowledge of insurance payer follow-up processes and payment structures.
• Skills & Abilities:
  • Strong attention to detail and ability to manage high volumes of data.
  • Excellent communication skills, with the ability to resolve patient and payer issues professionally.
  • Proficiency in billing software and systems.
  • Ability to work independently, manage your time effectively, and meet deadlines.

As a Billing Specialist , you'll be responsible for ensuring that claims are processed efficiently, payments are posted correctly, and outstanding denials are resolved promptly. You’ll also interact with insurance companies, patients, and internal teams to ensure maximum reimbursement and a seamless billing process. This is a critical role in our revenue cycle department, and you will have the opportunity to make a meaningful difference in our organization's financial success.

• Claims Processing & Management:

  • Process primary and secondary claims (electronic and paper), ensuring accuracy to minimize denials and optimize reimbursement.
  • Resolve claim scrubber edits, denials, and A/R reports in a timely manner to ensure claims are paid correctly.
  • Electronically bill primary payers and file secondary claims, making necessary adjustments as insurance information becomes available.

• Payer Communication & Follow-Up:

  • Work directly with insurance payers to resolve patient account issues, ensuring timely reimbursement.
  • Handle denied claims and A/R issues, submitting corrections and appeals to maximize collections.

• Patient Account Management:

  • Clearly explain billing statements to patients, addressing questions about insurance and out-of-pocket responsibilities.
  • Offer solutions to patient billing issues, providing compassionate and clear communication to reduce anxiety.

• Appeals & Adjustments:

  • Prepare and file appeals for denied claims and ensure all necessary information is submitted accurately.
  • Adjust patient accounts when required, such as addressing insurance timeliness or payer errors.

• Continuous Improvement:

  • Stay up to date with billing regulations, coding updates (CPT, ICD-9, ICD-10), and payer-specific requirements.
  • Share feedback with the Lead Biller and Revenue Cycle Manager to improve billing processes and identify system improvements.
  • Participate in educational opportunities and in-service meetings to enhance your professional development.

• Team Collaboration & Support:

  • Provide backup support for other departments as needed, such as assisting with admitting and emergency registration.
  • Maintain effective communication with colleagues across departments to ensure smooth operations.
  • Attend department meetings and work collaboratively to resolve any billing-related concerns.

• Confidentiality & Professionalism:

  • Always maintain confidentiality of patient and financial information.
  • Demonstrate professionalism and empathy in all communications with patients and their families.

• 100% Remote Opportunity: This position is fully remote for residents of Idaho.
• Office-based environment with potential exposure to patient elements (if applicable).
• Potential exposure to bloodborne pathogens (standard health protocols are followed).
• Physical demands include sitting at a computer, walking, reaching, and speaking.

• Occasional overtime or weekend shifts may be required depending on department needs.
• This role offers the chance to work in a collaborative and growing healthcare team, with ample opportunities for career advancement within the revenue cycle field.

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