Insurance Billing Specialist
Hopedale Medical Complex, Hopedale, IL, United States
Insurance Billing Specialist
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
12 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
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
12 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