Billing Specialist

The Billing Specialist is responsible for accurate and timely billing and follow-up of hospital, professional and home health & hospice claims within a Critical Access Hospital. This position performs a variety of revenue cycle functions, including charge review, claim submission, insurance follow-up, payment posting, denial resolution, accounts receivable management, and prior authorization processing. The Billing Specialist works closely with clinical departments, registration, coding, HIM, payers, and patients to ensure claims are accurate, compliant, and reimbursed appropriately. The position requires strong attention to detail, organization, problem solving skills, and the ability to work effectively with multiple payers and departments. Knowledge of healthcare billing, Medicare, Medicaid, commercial insurance, and CPT, HCPCS, and revenue code requirements is preferred but not required; comprehensive training will be provided to candidates who demonstrate the appropriate skills, aptitude, and willingness to learn. The Billing Specialist will utilize the Epic and Netsmart system to perform billing and revenue cycle functions while maintaining accuracy, confidentiality, productivity, and excellent customer service.

            Education: High school graduate or equivalent.

Experience: Previous healthcare, medical billing, insurance, or revenue cycle experience preferred. Strong attention to detail, organization, accuracy, and problem-solving skills. Ability to communicate effectively and work collaboratively with patients, staff, and insurance payers. Basic computer skills and the ability to learn and navigate electronic systems. Experience with Epic, Netsmart, medical billing, or insurance is preferred but not required; training will be provided for the right candidate. Ability to maintain confidentiality and comply with HIPAA and organizational policies.

Alternative to Minimum Qualifications: Equivalent experience or demonstrated ability may be considered; on-the-job training will be provided.