Insurance Billing Specialist, Full-time

Insurance Billing SpecialistHopedale Medical Complex is seeking an experienced Insurance Billing Specialist to join our Patient Financial Services team. This position is responsible for obtaining accurate, ethical, and timely reimbursement for hospital and hospital-based services and managing all aspects of insurance claim billing and follow-up.The Insurance Billing Specialist processes insurance claims, researches and resolves denials and discrepancies, follows up on outstanding accounts, reviews insurance payments, manages assigned accounts receivable, and assists patients and insurance companies with billing-related questions.The successful candidate will have strong problem-solving and organizational skills, exceptional attention to detail, excellent telephone and customer service skills, and the ability to work independently while maintaining accuracy and productivity. This is an onsite position in Hopedale, Illinois.

Candidates must be willing and able to reasonably commute to the Hopedale Medical Complex campus. This position is not eligible for remote work.Essential Duties and Responsibilities:Insurance Claim BillingInsurance Claim Follow-UpInsurance Payment Review and ReimbursementAccounts Receivable ManagementOther ResponsibilitiesRequired Qualifications:High school diploma or equivalent required.One to two years of experience in a medical business office, preferably with experience in insurance claim billing and follow-up.Working knowledge of Medicare Part A, Medicaid, and commercial insurance billing procedures.Knowledge of medical billing and collection procedures.Demonstrated working knowledge of computerized medical information management systems.Proficiency with Microsoft Office applications, including Word, Excel, and Outlook.Strong verbal and written communication skills.Excellent telephone communication and customer service skills.Strong organizational skills and exceptional attention to detail.Ability to analyze billing issues, identify discrepancies, and resolve problems effectively.Ability to work independently with general supervision.High level of dependability, accuracy, and accountability.Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their office staff, and third-party insurance representatives.Ability and willingness to work onsite at Hopedale Medical Complex in Hopedale, Illinois.Preferred Qualifications:Some college coursework preferred.Previous experience with hospital billing and hospital-based services preferred.Experience with Medicare, Medicaid, and commercial insurance claim follow-up preferred.Experience with UB-04 claims preferred.Experience with CPSI, TruBridge, or similar healthcare billing systems preferred.Experience working with insurance denials, appeals, contractual allowances, and accounts receivable preferred.Physical Requirements:Constantly (67–100%): Sitting, talking, hearing, near visual acuity, and repetitive hand/wrist motion associated with computer work, telephone communication, data entry, and documentation.Frequently (34–66%): Reaching, handling paperwork, operating office equipment, and moving throughout the assigned work area.Occasionally (11–33%): Standing, walking, bending, stooping, and carrying or lifting office materials and supplies.Rarely (less than 10%): Pushing or pulling carts, equipment, or other materials associated with office operations.Work Environment:Work is performed in an office-based healthcare environment within Hopedale Medical Complex.The position involves frequent interaction with patients, insurance representatives, physicians and their office staff, hospital employees, and other healthcare professionals.The work environment may involve frequent interruptions, changing priorities, deadlines, and confidential patient and financial information.The employee is expected to maintain professionalism, confidentiality, accuracy, and appropriate customer service at all times.Background Check and Drug Screen:All HMC employees are required to successfully complete applicable federal and state background checks and a pre-employment drug and alcohol screening. HMC's drug screening process includes testing for substances prohibited under HMC policy, including cannabis (THC), consistent with applicable law and organizational requirements.Equal Employment Opportunity:Hopedale Medical Complex is an Equal Opportunity Employer.

Employment decisions are made without regard to race, color, religion, sex (including pregnancy, sexual orientation, gender identity, and gender expression), national origin, age, disability, genetic information, veteran status, military status, or any other characteristic protected by applicable federal, state, or local law.ADA Accommodation:Hopedale Medical Complex provides reasonable accommodations to qualified individuals with disabilities. Applicants or employees requiring an accommodation during the application, hiring, or employment process should contact the Human Resources Department.E-Verify:Hopedale Medical Complex participates in E-Verify. In compliance with federal law, individuals hired will be required to verify their identity and authorization to work in the United States and complete the required employment eligibility verification process.

E-Verify will be used in accordance with applicable federal requirements.Disclaimer:This job description is intended to describe the general nature and level of work performed by individuals assigned to this position. It is not intended to be an exhaustive list of all duties, responsibilities, qualifications, or working conditions. Hopedale Medical Complex reserves the right to modify this job description at any time based on organizational needs.