Medical Billing Specialist |Full-Time|

Heritage Health•Coeur d'Alene, ID

8d•Onsite

About The Position

Heritage Health is seeking a detail-oriented and proactive Billing Specialist to support accurate, efficient billing operations and patient care through timely financial processes. The role manages patient accounts, processes claims, resolves denials, and supports eligibility services. The Billing Specialist works with internal teams and external payers to maintain revenue cycle operations and support accessible, high-quality healthcare. The role is part of Heritage Health's Patient Centered Medical Home (PCMH) Care Team. Regular and predictable attendance is an essential function; other miscellaneous job-related duties may be assigned. Work is normally performed in a typical interior office environment in an administrative building, though work may be demanding and chaotic at times. The employee may encounter patients with contagious diseases, physical injuries, and varied emotional states. Physical and mental requirements include prolonged sitting and computer work, occasional lifting of up to 15 pounds, navigating various departments, completing tasks in noisy or stressful environments, and adhering to process protocols. Employees are responsible for helping maintain a safe work environment, completing required training, participating in emergency response tasks and safety committees as requested, following safety instructions, reporting or correcting hazards, and providing safety feedback to supervisors and management.

Requirements

High school graduate or equivalent.
Two years of medical billing experience, or an equivalent combination of experience, training, and/or education.
Working knowledge of accounts receivable.
Working knowledge of CPT and ICD-10 codes and medical terminology.
Up-to-date knowledge of health information technologies and applications.
Ability to establish and maintain effective working relationships with employees, patients, organizations, and the public.
Ability to read and interpret insurance explanations of benefits.
Ability to communicate effectively in writing, over the phone, and in person.
Proficiency in Microsoft Office, including Outlook, Word, and Excel.
Service orientation and attention to detail in a fast-paced environment.
Ability to sit for prolonged periods, work on a computer, lift up to 15 pounds at times, navigate various departments, and complete tasks in noisy or stressful environments.
Ability to adhere to process protocols and follow safety instructions.

Responsibilities

Work accounts receivable and follow up on unpaid claims aged over 30 days using monthly aging reports.
Handle coding-related inquiries and denials by researching, appealing, and recommending solutions.
Manage held or rejected claims in a timely manner.
Follow up promptly on insurance claim denials, exceptions, and exclusions.
Process charges promptly and append necessary modifiers.
Verify claims for completeness and accuracy before submission.
Ensure insurance company and patient payments are posted accurately.
Review credit balances and take timely action.
Respond to inquiries from insurance companies, patients, and providers using payer websites.
Communicate payer, front-desk, and other trends that may disrupt cash flow to the Billing Supervisor.
Participate as a member of the Heritage Health PCMH Care Team.
Maintain regular and predictable attendance and perform miscellaneous job-related duties as assigned.
Complete required safety training, participate in emergency response and safety activities as requested, and help maintain a safe working environment.

Benefits

Employer-paid employee medical, dental, and vision coverage for full-time employees.
Employer-paid life insurance equal to one times annual salary, with optional additional coverage available at additional cost.
Short-term disability insurance based on age and salary.
Employer-paid long-term disability insurance.
403(b) retirement plan with employer matching up to 4% of employee contributions.
120 hours of paid time off in the first year.
56 hours of Extended Illness Bank in the first year.
Eight paid holidays for full-time employees.
Free telehealth visits for healthcare, counseling, and health and wellness coaching for employees and immediate household members.
No weekends or holidays.