Insurance Billing Specialist – Job Description Wallowa Memorial Hospital and Medical Clinics is seeking a detail-oriented, dependable Insurance Billing Specialist to join our Business Office team. This position plays an essential role in supporting the financial and administrative operations of the District through accurate insurance claim processing, accounts receivable management, and health information management. The Insurance Billing Specialist is responsible for preparing and submitting medical claims, resolving billing discrepancies, following up on outstanding accounts, and maintaining accurate patient health records. Additional responsibilities include coordinating the release of information (ROI) process, reviewing medical records for completeness, managing electronic health documentation, and ensuring compliance with applicable privacy and regulatory requirements. This position requires strong organizational skills, attention to detail, sound judgment, and a commitment to providing exceptional service while supporting our mission, "To Provide Premier Health Care."
Responsibilities include:
Prepare, review, and submit electronic and paper insurance claims to Medicare, Medicaid, and commercial insurance payers.
Monitor outstanding accounts, investigate claim denials and reimbursement discrepancies, and complete necessary follow-up, corrections, and appeals.
Maintain accurate billing records, reconcile payment information, and manage assigned work queues to support timely reimbursement.
Communicate with insurance representatives, patients, and internal departments regarding billing inquiries, claim status, and account resolution.
Compile, process, and maintain electronic and paper patient health records in accordance with regulatory requirements and District policies.
Review medical records for completeness and accuracy, identify documentation deficiencies, and coordinate with providers to ensure timely completion.
Coordinate the release of information (ROI) process, including verifying authorizations, preparing records, tracking disclosures, and responding to authorized requests.
Scan, index, and verify medical documentation within the electronic health record (EHR), ensuring accurate patient identification and record integrity.
Complete and submit required birth certificate documentation to the appropriate state agency.
Assist with medical record requests related to audits, legal proceedings, regulatory reviews, and quality improvement activities.
Maintain patient confidentiality and ensure compliance with HIPAA, applicable regulations, and organizational policies.
Provide exceptional customer service and cross-functional support for Business Office and Health Information Management operations.
Qualifications:
High school diploma or equivalent required; coursework in bookkeeping, typing, grammar, and mathematics preferred.
Coursework or demonstrated knowledge of medical terminology required.
Previous experience in healthcare, patient registration, medical billing, or customer service desirable.
One year of experience in health information management, medical records, or a related healthcare office setting preferred.
Experience with electronic health record (EHR) systems and document imaging preferred.
Registered Health Information Technician (RHIT) credential preferred but not required.
Working knowledge of medical billing procedures, insurance claim processing, medical coding systems, and accounts receivable practices.
Familiarity with HIPAA regulations, patient confidentiality standards, and release of information requirements preferred.
Strong computer proficiency, organizational skills, and attention to detail, with the ability to manage multiple priorities and maintain accurate records.
Excellent written and verbal communication skills with the ability to interact professionally and compassionately with patients, providers, insurance representatives, and colleagues.
Strong analytical and problem-solving abilities with a commitment to accuracy, regulatory compliance, and exceptional customer service.
Ability to meet the physical and functional requirements outlined in the job description, with or without reasonable accommodation.
Must successfully pass a criminal background check, drug screen, and reference checks.
EEOC/ACCOMMODATION STATEMENT:Wallowa County Health Care District is a drug and alcohol-free workplace and an Equal Opportunity Employer. All offers of employment are contingent upon the successful completion of background and drug screenings. Please note that we adhere to federal guidelines regarding prohibited substances, including those that may be legal under state law.
Applicants who require a reasonable accommodation during the application or recruitment process are encouraged to contact the Human Resources Department for assistance.
Paper applications may be obtained at Wallowa Memorial Hospital.
Please email Jennifer, HR Coordinator, at Jennifer.Medford@wchcd.org for any further inquiries.
Salary Range: $25.08 + DOE
