Medical Billing & Collections Specialist

Logan Health

2d•Remote

About The Position

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, this role works heavily with Medicare and Medicare Advantage plans and requires familiarity with governmental regulations and guidelines. The applicant 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, this position supports operational excellence and contributes to the organization’s financial health.

Requirements

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.

Nice To Haves

Experience with Medicare and/or Medicaid UB-04 & CMS-1500 claim forms.
Advanced skills in Electronic Medical Record Billing systems, including Meditech and Cerner.
Proficiency in Microsoft Office Suite, particularly intermediate skills in Excel (e.g., data entry, formulas, basic functions), Microsoft Teams Outlook.
Strong time management, organizational, and relationship-building skills.
Ability to prioritize tasks in a fast-paced environment with minimal supervision.
Maintains regular and consistent attendance as scheduled by department leadership.

Responsibilities

Submit and monitor claims to primary, secondary, and/or tertiary insurance companies according to insurance guidelines.
Perform follow-up on unpaid insurance claims identified via aging reports.
Review and process claim appeals and refund requests as needed.
Identify and report trends and insurance issues related to billing and reimbursement to leadership.
Maintain Privacy & Confidentiality of patient information and organizational operations in accordance with HIPAA.
Reallocate and settle misapplied insurance payments and adjustments.
Assist with special projects when needed.