Insurance Billing Specialist-1.0 FTE

OMC Core Behavior Standards:

Create Teamwork Lead with Honesty & Integrity Convey Compassion Show Respect Pursue Quality Osceola Medical Center is committed to implementing these behavior standards as a foundation for how we hire, develop, and retain our team members. By intentionally selecting candidates whose values and behaviors align with these standards, we ensure that our mission is lived out every day, creating an environment where patients feel valued, respected, and confident that OMC is the place for all their healthcare needs.

Job Summary:

The Insurance Billing Specialist is responsible for submitting and managing insurance claims within the Epic EMR system. This role investigates and resolves claim errors and denials, processes appeals, and identifies billing trends requiring escalation. The Insurance Billing Specialist plays a key role in ensuring accurate, timely reimbursement while supporting hospital and clinic revenue cycle operations.

Work Schedule:

Monday - Friday;

Day Shift Qualifications:

High school diploma or GED required; additional medical billing education preferred. Experience with hospital, clinic, or CAH/RHC billing. Knowledge of

CPT, ICD-10, HCPCS

coding, and claim processing rules. Proficiency in

EPIC EMR

system preferred. Strong organizational, problem-solving, and communication skills.

Responsibilities include:

Submit accurate and timely insurance claims using Epic EMR Identify and correct billing-related errors preventing claim submission Investigate and resolve claim denials using billing work queues Perform payer follow-up as assigned to ensure timely resolution Process appeals in accordance with federal, state, and payer guidelines Document all actions taken on claims and appeals within the system Identify and escalate recurring issues, trends, or payer patterns to the Lead Biller or Billing Manager Collaborate with internal teams and departments to ensure efficient revenue cycle workflows

Knowledge, Skills, and Abilities:

Knowledge of hospital and clinic billing processes, including Medicare, Medicaid, and commercial payer requirements Understanding of CPT, HCPCS, ICD-10-CM, and revenue codes, as applicable Familiarity with claims submission, payment posting, denials, adjustments, and appeals processes Proficiency with electronic medical record and billing systems (Epic or comparable systems) Strong attention to detail with the ability to maintain accuracy and meet deadlines Effective written and verbal communication skills Ability to analyze and resolve billing discrepancies and payer rejections Ability to manage multiple priorities in a fast-paced healthcare environment Ability to maintain HIPAA compliance and handle confidential information appropriately Ability to work independently and collaboratively within revenue cycle and clinical teams Physical Requirements for the

Role:

Example:

standing for long periods of time, manual dexterity required to manipulate small objects such as a keyboard, etc.

Work Environment:

Hybrid office-based environment with the hospital setting and remote at home Occasional interactions with patients and clinical staff Standard work hours with occasional overtime as needed. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Behavior-Based Leadership Expectations:

Successful candidates will: Treat every patient, visitor, and team member with dignity and respect Take ownership of their actions and follow through on commitments Adapt positively to change and support new initiatives Contribute to a culture of trust, collaboration, and accountability Consistently act in ways that support OMC's mission and values Why Join OMC? At OMC, we don't just hire for skills—we hire for behaviors that align with our mission. We invest in team members who are committed to making a meaningful difference in the lives of our patients and in the communities we serve. Osceola Medical Center is an equal opportunity employer and is committed to creating an inclusive environment for all employees.