Medical Billing & Collections Specialist

Posted:
12/16/2024, 4:00:00 PM

Location(s):
West Virginia, United States

Experience Level(s):
Junior

Field(s):
Medical, Clinical & Veterinary

Workplace Type:
Remote

Job Description Summary:

At Logan Health, we're more than just a healthcare provider—we're a community. Nestled in the heart of Montana, we are committed to delivering exceptional care to our patients while fostering a supportive and collaborative work environment for our team. As a member of Logan Health, you'll be part of a dynamic team that values compassion, innovation, and excellence. We offer opportunities for growth, comprehensive benefits, and a chance to make a meaningful impact in the lives of those we serve. Come join us and experience the Logan Health difference, where your passion meets purpose in a place you’ll be proud to call home.

The Medical Billing & Collections Specialist plays a vital role in ensuring the accuracy, completeness, and timeliness of claim submissions, closely monitoring claim statuses, investigating rejections and denials, and documenting all account activities. This role requires strong critical thinking skills and an in-depth understanding of insurance eligibility, payment methodologies, and contractual adjustments based on government regulations.

Additionally, the specialist must demonstrate proficiency in billing systems to optimize efficiency, ensure compliance, and facilitate the seamless processing of claims. With a keen attention to detail and expertise in navigating complex insurance requirements, the Medical Billing & Collections Specialist supports operational excellence and contributes to the organization’s financial health.

Key Responsibilities:

  • Process claims to appropriate primary, secondary, and/or tertiary insurance company according to insurance guidelines.

  • Perform follow-up on unpaid insurance accounts identified through aging reports.

  • Process appeals when appropriate.

  • Process refund requests.

  • Identify trends, and carrier issues relating to billing and reimbursements, report findings to leadership.

  • Maintain Privacy & Confidentiality of patient information and organizational operations.

  • Responsible for learning, understanding and following payer guidelines.

  • Reallocate misapplied payments and adjustments.

  • Work special assignments when needed.

Basic Qualifications:

  • 2+ years of experience in a business, medical, or clinical environment.

  • Proficiency in Electronic Medical Record (EMR) billing systems.

  • Strong knowledge of medical terminology and health insurance guidelines.

  • Fluent in English, both spoken and written.

Preferred Qualifications:

  • Experience with specific EMR systems, including Meditech and Cerner.

  • Proficiency in Microsoft Office Suite, particularly intermediate skills in Excel (e.g., data entry, formulas, basic functions).

  • Ability to work effectively in a fast-paced, dynamic environment with strong time management and organizational skills.

  • Demonstrated ability to prioritize tasks and complete work with minimal supervision.

  • Proven ability to build and maintain professional relationships.

  • Consistent and reliable attendance as scheduled by leadership.

This position offers full-time remote work.

To be eligible, you must reside in one of the following states:  

  • Arkansas

  • Arizona

  • Colorado

  • Florida

  • Hawaii

  • Idaho

  • Illinois

  • Indiana

  • Kansas

  • Michigan

  • Missouri

  • Montana

  • Minnesota

  • New Mexico

  • North Carolina

  • Ohio

  • Oregon

  • South Dakota

  • Tennessee

  • Texas

  • Virginia

  • Washington

  • Wyoming

Shift:

Day Shift - Variable Hours (United States of America)

Schedule Details:

Please know schedules and shifts are subject to change based on patient care and department/organizational needs.

We are committed to creating a supportive, team-driven environment where your skills can flourish. Our organization operates 24/7, offering flexibility in your schedule while empowering you to be a part of something bigger—improving healthcare outcomes for all.

Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

Notice of Pre-Employment Screening Requirements

If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes:

  • Criminal background check

  • Reference checks

  • Drug Screening

  • Health and Immunizations Screening

  • Physical Demand Review/Screening

Equal Opportunity Employer

Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.