Process claims to appropriate primary, secondary, and/or tertiary insurance company according to insurance guidelines.
Perform follow-up on unpaid insurance accounts identified through aging reports.
Process appeals when appropriate.
Process refund requests.
Identify trends, and carrier issues relating to billing and reimbursements, report findings to leadership.
Maintain Privacy & Confidentiality of patient information and organizational operations.
Responsible for learning, understanding and following payer guidelines.
Reallocate misapplied payments and adjustments.
Work special assignments when needed.
Requirements
1+ year(s) 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.
2+ years of experience in a business, medical, or clinical environment.
Experience with specific EMR systems, including Meditech and Cerner.
Proficiency in Microsoft Office Suite, particularly intermediate skills in Excel (e.g., data entry, formulas, basic functions).
Ability to work effectively in a fast-paced, dynamic environment with strong time management and organizational skills.
Demonstrated ability to prioritize tasks and complete work with minimal supervision.
Proven ability to build and maintain professional relationships.
Consistent and reliable attendance as scheduled by leadership.
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Minimum of one (1) year experience in a hospital or medical office setting preferred.
Proficient with basic accounting and ten-key by touch preferred. Prior experience with business mathematical tasks and correspondence preferred.
Excellent interpersonal and customer service skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
Possess and maintain computer skills to include working knowledge of Word, Outlook, Excel, and ability to learn other software as needed. Proficiency in Excel preferred.
Possess ability to maintain confidentiality and understand HIPAA guidelines and other applicable federal laws.
Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.
Commitment to working in a team environment and maintaining confidentiality as needed.
Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.
Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
Possess and maintain computer skills to include working knowledge of Microsoft Office Suite and ability to learn other software as needed.
Job Specific Duties:
Analyzes and interprets account data to facilitate timely claim and payment resolution as applicable to assigned area(s). Collaborates and/or refers unresolved issues and escalates to ap
Benefits
Health insuranceVision insurance
Additional Information
At Logan Health, we're more than just a healthcare provider-we're a community. Nestled in the heart of Montana, we are committed to delivering exceptional care to our patients while fostering a supportive and collaborative work environment for our team. As a member of Logan Health, you'll be part of a dynamic team that values compassion, innovation, and excellence. We offer opportunities for growth, comprehensive benefits, and a chance to make a meaningful impact in the lives of those we serve. Come join us and experience the Logan Health difference, where your passion meets purpose in a place you'll be proud to call home.
Our Mission : Quality, compassionate care for all.
Our Vision : Reimagine health care through connection, service and innovation.
Our Core Values : Be Kind | Trust and Be Trusted | Work Together | Strive for Excellence.
Join the Patient Accounting Team at Brendan House!
Location: Logan Health Brendan House - Kalispell, Montana
Shift: Day Shift - 8 Hours | Part-Time - 24 Hours
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, the specialist 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, the Medical Billing & Collections Specialist supports operational excellence and contributes to the organization's financial health.
Loganhealth · Kalispell, MT