Medical Billing Specialist |Full-Time|

Billing Specialist

Heritage Health is seeking a full-time (1.0 FTE) Billing Specialist to join our team in Coeur d'Alene, Idaho. This role is essential to ensuring the accuracy and efficiency of our billing operations, supporting patient care through timely and precise financial processes.

As a Billing Specialist, you will be responsible for managing patient accounts, processing claims, resolving denials, and supporting eligibility services. You'll work closely with internal teams and external payers to maintain smooth revenue cycle operations and contribute to our mission of delivering high-quality, accessible healthcare.

Requirements:

• High school graduate or equivalent
• Two (2) years' experience of medical billing or any equivalent combination of experience, training and/or education.

Your Essential Duties:

• Knowledge of working AR (Account Receivable).
• Handle coding-related inquiries and denials, research, appeal, and provide solution recommendations.
• Manage held or rejected claims in a timely manner.
• Timely follow-up on insurance claim denials, exceptions or exclusions.
• Timely charge acceptance/processing and appending necessary modifiers.
• Verify the completeness and accuracy of all claims prior to submission.
• Knowledge of insurance company and patient payments posting for accuracy.
• Review credit balances and take action in a timely fashion.
• Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
• Respond to inquiries from insurance companies, patients and providers With working knowledge of Payer Websites.
• Timely communication to the Billing Supervisor regarding trends with payors/front desk and other issues that are potentially disruptive to cash flow.
• Heritage Health staff have an active role in our Patient Centered Medical Home model of care. This role is designated as part of the Heritage Health PCMH Care Team.
• Regular and predictable attendance is an essential function of this position.
• Performs miscellaneous job-related duties as assigned.

Your Success Factors:

• Working knowledge of CPT and ICD10 codes and medical terminology.
• Up to date with health information technologies and applications.
• Skill in establishing and maintaining effective working relationships with other employees, patients, organizations and the public.
• Ability to read and interpret insurance explanation of benefits.
• Ability to communicate effectively in writing, over the phone, and in person.
• Proficient in Microsoft Office including Outlook, Word and Excel.
• Be service-oriented with the ability to pay attention to details in a fast-paced environment.

Working Conditions: Work is normally performed in a typical interior, office work environment in an administrative building. Work may be demanding and chaotic at times. May be exposed to patient population that will present a variety of contagious diseases, physical injuries and emotional states of mind.

Physical/Mental Requirements:

• Prolonged periods of sitting, and working on a computer.
• May lift up to 15 pounds at times.
• Must be able to access and navigate various departments of a given location.
• Must be able to complete tasks in a noisy or stressful environment.
• Must be able to adhere to process protocol.

Safety: Heritage Health enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions and providing feedback to supervisors and management on all safety issues