Medical Billing & Collections Specialist | Hybrid

Join The Patient Accounting Team!

At Logan Health, we're more than just a healthcare providerwe'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.

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.

Key Responsibilities:

• 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.

Basic Qualifications:

• 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.

Preferred Qualifications:

• 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.

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 appropriate party.
• Posts payments and adjustments utilizing the appropriate fee schedule, policy and/or procedures in accordance with patient statements, remittance advices, insurance carriers, electronic downloads, etc. and as applicable to assigned area(s).
• Identifies credits, variances and trends. Performs appropriate action to facilitate resolution in a timely manner.
• Documents all communication, both written and verbal, in an accurate, clear and factual manner.
• Completes account maintenance review to ensure account information is accurate within billing system.
• Acts as a Patient Accounting liaison between patients, clients, providers, payers, vendors and other Logan Health departments as applicable to assigned area(s).
• Interprets explanation of benefits (EOB) message codes, validates payer processing and identifies potential payment discrepancies as applicable to assigned area(s).
• Effectively manages assigned work in accordance with team expectations, department productivity, and quality standards and as applicable to assigned area(s).
• Provides exceptional customer service to stakeholders for questions and concerns.
• Responsible for all Medicare, Medicaid, and Case Management insurance denials processing as applicable to assigned area(s).
• Responsible for all insurance appeals and works with appropriate stakeholders to ensure completion as applicable to assigned area(s).
• Serves as point of contact for quotes, equipment authorization, etc. as applicable to assigned area(s).

Maintain regular and consistent attendance as scheduled by department leadership.

Shift: Day Shift - Variable Hours (United States of America)

Location: Hybrid (on-site & remote) | Kalispell, Montana Shift: Day Shift Variable Hours | Full-Time 40 Hours

Logan Health operates 24 hours per day, seven days per week. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

Notice of Pre-Employment Screening Requirements

If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes:

• Criminal background check
• Reference checks
• Drug Screening
• Health and Immunizations Screening
• Physical Demand Review/Screening

Equal Opportunity Employer

Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.