Improving Lives Together
Magruder Hospital offers competitive wages with a comprehensive benefit package available to both full-time and part-time employees. We provide a full health plan and generous time off that includes Holidays, Vacation, Sick, Personal, and even your Birthday! Our culture and family friendly work environment truly set us apart- apply today for an opportunity to join our team and help serve this great community!
Position Summary:
We are seeking a Medical Billing Specialist to manage insurance billing for hospital and provider services. This role ensures accurate claim submission, timely follow-up, and compliance with all regulatory requirements. The ideal candidate has experience in healthcare billing, insurance claims processing, and a strong understanding of the Revenue Cycle.
- Submit and follow up on insurance claims for hospital and provider services until payment is received.
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Secure required medical documentation for third-party insurance carriers.
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Resolve patient billing inquiries, denials, and payment discrepancies.
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Accurately enter charges, payments, adjustments, and claim corrections in electronic systems.
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Complete initial and secondary billing, including electronic and paper claims.
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Ensure compliance with CPT coding, pre-certification, and payer requirements.
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Monitor and reduce accounts receivable days through timely follow-up.
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Verify HMO, PPO, and managed care payments and contractual adjustments.
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Identify and process credit balances for refunds or transfers.
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Collaborate with Health Information Coders and other departments for diagnosis follow-up.
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Maintain compliance with HIPAA, Joint Commission, and corporate policies.
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Report recurring errors and assist with posting issues as needed.
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Prioritize workload effectively and work both independently and as part of a team.
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Communicate clearly in writing and verbally with patients, payers, and internal teams.
- Competitive pay and benefits.
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Collaborative team environment.
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Opportunity to make a meaningful impact in healthcare finance.
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High School Diploma or GED equivalent.
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Excellent typing, data entry, math, analytical, customer, stress management, organizational and problem-solving skills.
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Proficient in the use of personal computers and various types of office equipment. Has a strong working knowledge of PC based Word Processing and Spreadsheet applications, preferably Microsoft Office products (Word, Excel, Outlook).
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Ability to work in a safe and efficient manner and maintain an accident-free workplace, including ability to demonstrate a working knowledge of Magruder Hospital emergency codes.
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Strong working knowledge of departmental policies, procedures and business operations and how they interrelate to other departments in the organization.
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Strong knowledge of insurance and/or account follow-up.
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General knowledge of accounting systems and procedures.
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Must be able to see, hear, respond, and communicate efficiently to the customer, patients and to calls received. Must be able to interact efficiently with others.
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Must be detail-oriented to research accounts to determine proper payment and verify correct adjustments for accounts.
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Must have the ability to deal with constant interruptions with poise, tact, and professionalism, while maintaining a positive image for the hospital.
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Knowledge and understanding of billing form UB-04, 1500 and ICD-10 Coding.
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Knowledge of hospital and/or medical billing and insurance claim filing.
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Insurance and/or account follow-up.
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Knowledge of medical and insurance terminology.
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Participant in special workshops of training sessions in Medicare, Medicaid and non-government payers procedures to maintain a current, knowledgeable position relative to these procedures.
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Third party billing and collections
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Basic knowledge of medical and insurance terminology.
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Minimum 1 year experience in a Customer Service setting.
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1 year hospital billing business office experience.
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Maintains a positive impression at all times.
Preferred:
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Associates Degree in Medical Billing and Coding or related field
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Knowledge of automated systems preferred
Magruder Hospital is an Equal Opportunity Employer and provides equal employment and advancement opportunities to all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, veteran status, disability, or any other protected class under the law.
Magruder Hospital is a Drug Free Workplace. Any offer of employment will be contingent upon satisfactory completion of pre-employment drug screening, including screening for the presence of nicotine, satisfactory completion of background verification, and the results of a post-offer medical examination, if required by the hospital.
