Billing Specialist III at Melissa Memorial Hospital

Description

*Remote Work Eligible*

JOB SUMMARY:

The Billing Specialist III is responsible for performing advanced billing functions within the hospital's revenue cycle. This role includes preparing, reviewing, and submitting medical claims to insurance companies, government payers, and patients. The Billing Specialist III also resolves billing discrepancies, processes payments, and communicates with patients and insurance representatives to ensure accurate and timely reimbursement.

ESSENTIAL DUTIES:

• Prepare and submit hospital and professional billing claims (UB-04 and CMS-1500) to insurance companies and government payers
• Review patient accounts to ensure accuracy of charges, insurance information, and coding prior to claim submission.
• Follow up on unpaid or denied claims and initiate corrective action or resubmissions as needed.
• Resolve billing discrepancies or errors, including researching patient records and coordinating with coding, registration, and medical staff.
• Process insurance and patient payments, including posting to accounts and issuing refunds or statements when applicable.
• Respond to billing inquiries from patients, insurance companies, and internal departments in a timely and professional manner.
• Assist with month-end closing processes and prepare billing reports or audits as needed.
• Stay current with payer rules and regulations, including Medicare, Medicaid, and commercial payers.
• Maintain compliance with HIPAA and all hospital billing and privacy standards.

*Other responsibilities and duties may be assigned as needed, based on the needs of Melissa Memorial Hospital.

COMPETENCIES:

• Support MMH vision and Mission
• Maintain confidentiality of all work information
• Demonstrate an ability to function successfully in a team environment
• Follow and role model the MMH Behavior Contract.
• Display a positive attitude and flexibility in changing situations
• Participate in identifying problems and suggesting solutions
• Report any compliance issues as designated in the MMH Compliance Program

Qualifications

QUALIFICATIONS:

       MINIMUM     

       Education:

• High school diploma or GED required.

       Experience:

• Minimum 7+ years of medical billing experience in a hospital setting.

      PREFERRED

• Associate’s degree in Accounting, Healthcare Administration, or related field preferred.

• Bilingual preferred but not required

      Experience:

• Experience with electronic health records (EHR) and billing systems (e.g., Athena, Epic, Cerner, Meditech) preferred.

• Knowledge of CPT, ICD-10, and HCPCS coding standards.

Skills:

• Strong knowledge of insurance billing procedures and payer requirements.

• Excellent attention to detail and problem-solving skills.

• Ability to prioritize and manage multiple tasks in a fast-paced environment.

• Strong communication and customer service skills.

• Proficient in Microsoft Office (Excel, Word, Outlook).

"This position will remain open until filled; however, applications will be reviewed on a rolling basis."

WHY WORK AT MELISSA MEMORIAL HOSPITAL? 

At Melissa Memorial Hospital, we’re a family not just a healthcare provider serving patients, staff, and community with care and inclusion. Here’s why you’ll thrive here:

• Core Values: Integrity, Passion, Service, Collaboration, Ownership, Courage drive us.

• Mission: “Compassionate care, nurturing trust.”, Tagline: “Seek Health. Live Well.”

• Eastern Plains Heart: A tight-knit team delivering impactful care.

• Balance: Work-life support plus the tools to excel in your current role and help you grow!

WHAT WE OFFER: 

• 100% Employer paid Medical (Employee Only) 

• Dental and Vision insurance 

• Retirement Plans, with up to 3% employer match 

• Voluntary Group Benefits 

• Employee Assistance Program 

• Gym Membership Discount 

• PTO, Paid Sick Time 

• Continuing Education Benefits 

• FSA 

• MASA Insurance 

• Eligibility for Student Loan Repayment  

MELISSA MEMORIAL HOSPITAL: 

Melissa Memorial Hospital is a 15-bed critical access hospital, located in Holyoke, Colorado. While being “rural” we are equipped for any situation. It is a model rural hospital with 1 operating room, surgical procedure room, 4 bay emergency room, and radiology including 64-slice CT scanner and mammography, MRI, ECHO, and Nuclear Medicine, along with other ancillary services. The hospital is co-located with a family practice clinic and retail pharmacy services. Other services include chemotherapy, general & orthopedic surgery, podiatry, cardiology, orthopedic surgery, progressive rehab services, and wound care. MMH operates a full-time EMS service and maintains a 24/7 AirLife Helicopter base. 

THE COMMUNITY: 

Holyoke is home to the Holyoke Dragons and is truly a “City of Pride and Progress.” Holyoke offers: 

From different coffee shops to different ethnic flavors, to a quick bite, the sweet small town of Holyoke has a handful of different restaurant options to choose from. 

Holyoke is based in Phillips County where there are four different rural towns in the county with two schools in the county. Holyoke, Amherst. Paoli, and Haxtun are all within the same county. Holyoke homes a historical museum with different artifacts of what has built Holyoke today. You will see the fields turn different colors throughout different seasons. Your wheat, corn, alfalfa, are some of the few cultivating growths that you will see around your area! If you enjoy hunting, there are plenty of opportunities for a good catch. You will discover that you can see the most beautiful sunsets and the clearest starry nights out in the rural areas. Come take a look at our beautiful little town in the Northeastern corner of Colorado. 

Click here for a List of Things to Do in Holyoke 

Melissa Memorial Hospital is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.