Insurance Billing Specialist

Insurance Billing Specialist Hopedale Medical Complex - 3.4 Hopedale, IL Job Details PRN 4 days ago Qualifications High school diploma or GED Full Job Description Insurance Billing Specialist (Onsite - Hopedale, IL) 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 1-2 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