Insurance Billing Specialist at Hopedale Medical Complex

Hopedale, Illinois, United States -

Full Time

Start Date

Immediate

Expiry Date

23 Jul, 26

Salary

0.0

Posted On

24 Apr, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance claims processing, Medical billing, Revenue cycle management, Medicare Part A, Medicaid, Commercial insurance, UB-04 claims, Payment posting, Reconciliation, Accounts receivable management, Appeals, CPSI, TruBridge, Microsoft Office, Attention to detail, Customer service

Industry

Hospitals and Health Care

Description

INSURANCE BILLING SPECIALIST (ONSITE – HOPEDALE, IL) We are seeking an experienced Insurance Billing Specialist to join our team onsite in Hopedale, IL. This role is responsible for ensuring accurate and timely reimbursement for hospital and hospital-based services while supporting the full lifecycle of insurance claims processing. This is a great opportunity for someone who is detail-oriented, analytical, and enjoys problem-solving in a fast-paced healthcare environment. ---------------------------------------- KEY RESPONSIBILITIES Insurance Claims Processing * Review patient accounts to verify accurate billing of services and charges * Prepare and submit clean UB-04 claims (electronic and paper) * Identify and resolve billing discrepancies prior to submission * Generate Medicare, Medicaid, and commercial insurance claims Claims Follow-Up & Resolution * Monitor and follow up on unpaid or denied claims * Investigate discrepancies and coordinate with internal/external stakeholders * Prepare and submit appeals with appropriate documentation * Maintain detailed documentation of all follow-up activities Payment Posting & Reconciliation * Review Explanation of Benefits (EOBs) for accuracy * Post payments and reconcile against contract terms * Calculate contractual adjustments as needed * Escalate non-collectible accounts with proper documentation Accounts Receivable Management * Maintain assigned A/R accounts at targeted levels * Ensure timely follow-up on outstanding balances * Resolve credit balances and process refunds when applicable Additional Responsibilities * Stay current on payer requirements and billing regulations * Support team training and act as a resource for billing questions * Assist patients and insurance providers with billing inquiries ---------------------------------------- QUALIFICATIONS * High school diploma required; some college preferred * 1–2 years of experience in medical billing or healthcare revenue cycle (preferred) * Working knowledge of Medicare Part A, Medicaid, and commercial insurance processes * Familiarity with medical billing systems (CPSI/TruBridge experience a plus) * Proficiency in Microsoft Office (Word, Excel, Outlook) * Strong attention to detail and organizational skills * Excellent communication and customer service skills * Ability to work independently with minimal supervision ---------------------------------------- WORK ENVIRONMENT * Onsite position in Hopedale, IL (not remote) * Must be able to commute reliably

Responsibilities

The Insurance Billing Specialist is responsible for the full lifecycle of insurance claims processing, including submission, follow-up, and resolution of denied claims. They also manage payment posting, reconciliation, and maintain accounts receivable at targeted levels.