Billing Specialist- Full- time- Remote

April 28, 2026 Auto Import

<ul> <li>Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.</li> <li>Review and prepare claims for manual and/or electronic billing submission.</li> <li>Reviews insurance rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding rejections.</li> <li>Correct and identify billing errors and resubmit claims to insurance carriers.</li> <li>Update CAS segments on secondary electronic claims as needed.</li> <li>Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.</li> <li>Verifies receipt of claim with insurance plans, determining the next appropriate action step.</li> <li>Researches all information needed to complete the billing process including obtaining information from providers, ancillary services staff, and patients.</li> <li>Obtains and attaches referrals to appointments/charges.</li> <li>Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.</li> <li>Identifies and communicates trends and/or potential issues to the management team.</li> <li>Follows and maintains all HOPCo policies and procedures.</li> <li>Other duties as assigned.</li> </ul> EDUCATION <ul> <li>High school diploma/GED or equivalent working knowledge preferred.</li> </ul> EXPERIENCE <ul> <li>Minimum of two to three years of experience in medical billing.</li> <li>Prior experience working on claim errors in a claims management system preferred.</li> <li>Must have strong knowledge of resolution to payor edit reports, and reconciliation of clearinghouse and payor acceptance reports.</li> <li>Candidates with knowledge of ANSI formatting preferred.</li> </ul> KNOWLEDGE <ul> <li>Knowledge of ICD-9, ICD-10, HCPS, and CPT coding, medical terminology, Medicare reimbursement guidelines, billing practices.</li> <li>Knowledge of government regulatory requirements and commercial contracts.</li> <li>Advanced computer knowledge, including Window based programs.</li> </ul> SKILLS <ul> <li>Skill in providing excellent customer service.</li> <li>Skill in using computer programs and applications.</li> <li>Skill in establishing good working relationships with both internal and external customers.</li> </ul> ABILITIES <ul> <li>Ability to multi-task in a fast-paced environment.</li> <li>Must be detailed oriented with strong organizational skills.</li> <li>Ability to understand patient demographic information and determine insurance eligibility.</li> <li>Ability to work independently and demonstrate the ability to analyze data.</li> </ul> ENVIRONMENTAL WORKING CONDITIONS <ul> <li>Normal office environment.</li> <li>Extended work hours at or near month end to meet department objectives may be necessary.</li> </ul>

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