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Bozeman Health · 1 month ago

Insurance Billing Specialist (FT- 1.0 FTE, Day Shift)

Bozeman, MT

Full-time

Onsite

Entry Level

1+ years exp

Bozeman Health is a healthcare provider seeking an Insurance Billing Specialist. The primary responsibility of this role is to ensure maximum reimbursement for hospital and professional claims by submitting accurate claims and following up on denials and other billing issues.

Health CareHospitalMedical

Responsibilities

Submits timely and accurate claims to primary, secondary, and tertiary insurances for both electronic and paper submission

Follows up on applicable No Response WQs and Rejected Claims WQs through phone contact or written correspondence to ensure that no account reaches 180 days old from discharge date and still due by insurance, regardless of dollar amount

Reviews accounts by verifying that reimbursement amounts are appropriate, coordination of refunds, if appropriate, and submitting adjustments for approval when necessary, routes claims for appeal, resubmits claims, or moves balances from insurance responsibility to patient responsibility when appropriate

Ensures that claims have appropriate information on them for submission to insurance companies or agencies by reviewing claim edit WQs and other prebilling insurance WQs and escalates systemic issues identified to supervisor

Assists Customer Service with claim processing questions

Identifies and escalates concerns regarding claim processing to Billing Supervisor

Qualification

Medical billing experienceClaims submissionHealthcare billing certificationOffice experienceJudgmentDiscretionCommunication skillsOrganizational skills