Insurance Billing Specialist

Hopedale Medical Complex seeks an Insurance Billing Specialist to manage accurate and timely billing for hospital, clinic, and senior services. Responsibilities include verifying insurance coverage, preparing and submitting claims, resolving denials, processing payments, and maintaining detailed account records. You will collaborate closely with clinical, admissions, and finance teams to support seamless patient experiences. This role thrives in a close-knit, rural health environment where accuracy, compassion, and communication help patients understand costs and coverage while supporting the financial health of our community-based campus.

Responsibilities

• Verify patient insurance coverage and benefits across hospital, clinic, and senior services
• Prepare, submit, and track electronic and paper insurance claims
• Research, correct, and resubmit denied or rejected claims
• Post and reconcile insurance and patient payments to accounts
• Communicate with insurers, patients, and internal teams to resolve billing issues
• Maintain accurate account records and documentation in EHR and billing systems
• Ensure compliance with Medicare, Medicaid, and payer-specific billing rules
• Protect patient privacy and follow HIPAA and organizational policies
• Generate and review billing and A/R reports to identify trends and issues
• Collaborate with clinical and admissions staff to support a positive patient financial experience

Required Skills

• Medical billing and coding
• Hospital and clinic claims processing
• Insurance verification
• Knowledge of Medicare/Medicaid rules
• EHR and billing software proficiency
• Accounts receivable management
• Denial management and appeals
• Payment posting and reconciliation
• HIPAA compliance
• Excel and basic reporting