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At Logan Health, we're more than just a healthcare provider—we're a community. Nestled in the heart of Montana, we are committed to delivering exceptional care to our patients while fostering a supportive and collaborative work environment for our team. As a member of Logan Health, you'll be part of a dynamic team that values compassion, innovation, and excellence. We offer opportunities for growth, comprehensive benefits, and a chance to make a meaningful impact in the lives of those we serve. Come join us and experience the Logan Health difference, where your passion meets purpose in a place you’ll be proud to call home.

Our Mission: Quality, compassionate care for all.

Our Vision: Reimagine health care through connection, service and innovation.

Our Core Values: Be Kind | Trust and Be Trusted | Work Together | Strive for Excellence.

Join the Patient Accounting Team!

The Medical Billing & Collections Specialist plays a vital role in ensuring the accuracy, completeness, and timeliness of claim submissions, closely monitoring claim statuses, investigating rejections and denials, and documenting all account activities. This role requires strong critical thinking skills and an in-depth understanding of insurance eligibility, payment methodologies, and contractual adjustments based on government regulations.

Additionally, this role works heavily with Medicare and Medicare Advantage plans and requires familiarity with governmental regulations and guidelines. The applicant must demonstrate proficiency in billing systems, to optimize efficiency, ensure compliance, and facilitate the seamless processing of claims. With a keen attention to detail and expertise in navigating complex insurance requirements, this position supports operational excellence and contributes to the organization’s financial health.

Key Responsibilities:

+ Submit and monitor claims to primary, secondary, and/or tertiary insurance companies according to insurance guidelines.

+ Perform follow-up on unpaid insurance claims identified via aging reports.

+ Review and process claim appeals and refund requests as needed.

+ Identify and report trends and insurance issues related to billing and reimbursement to leadership.

+ Maintain Privacy & Confidentiality of patient information and organizational operations in accordance with HIPAA.

+ Reallocate and settle misapplied insurance payments and adjustments.

Basic Qualifications:

+ 2+ years of experience in a business, medical, or clinical environment.

+ Proficiency in Electronic Medical Record (EMR) billing systems.

+ Strong knowledge of medical terminology and health insurance guidelines.

+ Fluent in English, both spoken and written.

Preferred Qualifications:

+ Experience with Medicare and/or Medicaid UB-04 & CMS-1500 claim forms.

+ Advanced skills in Electronic Medical Record Billing systems, including Meditech and Cerner.

+ Proficiency in Microsoft Office Suite, particularly intermediate skills in Excel (e.g., data entry, formulas, basic functions), Microsoft Teams Outlook.

+ Strong time management, organizational, and relationship-building skills.

+ Ability to prioritize tasks in a fast-paced environment with minimal supervision.

+ Maintains regular and consistent attendance as scheduled by department leadership.

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Qualifications:

+ Minimum of one (1) year experience in a hospital or medical office setting preferred.

+ Proficient with basic accounting and ten-key by touch preferred. Prior experience with business mathematical tasks and correspondence preferred.

+ Excellent interpersonal and customer service skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.

+ Possess and maintain computer skills to include working knowledge of Word, Outlook, Excel, and ability to learn other software as needed. Proficiency in Excel preferred.

+ Possess ability to maintain confidentiality and understand HIPAA guidelines and other applicable federal laws.

+ Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.

+ Commitment to working in a team environment and maintaining confidentiality as needed.

+ Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.

+ Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.

+ Possess and maintain computer skills to include working knowledge of Microsoft Office Suite and ability to learn other software as needed.

Job Specific Duties:

+ Analyzes and interprets account data to facilitate timely claim and payment resolution as applicable to assigned area(s). Collaborates and/or refers unresolved issues and escalates to appropriate party.

+ Posts payments and adjustments utilizing the appropriate fee schedule, policy and/or procedures in accordance with patient statements, remittance advices, insurance carriers, electronic downloads, etc. and as applicable to assigned area(s).

+ Identifies credits, variances and trends. Performs appropriate action to facilitate resolution in a timely manner.

+ Documents all communication, both written and verbal, in an accurate, clear and factual manner.

+ Completes account maintenance review to ensure account information is accurate within billing system.

+ Acts as a Patient Accounting liaison between patients, clients, providers, payers, vendors and other Logan Health departments as applicable to assigned area(s).

+ Interprets explanation of benefits (EOB) message codes, validates payer processing and identifies potential payment discrepancies as applicable to assigned area(s).

+ Effectively manages assigned work in accordance with team expectations, department productivity, and quality standards and as applicable to assigned area(s).

+ Provides exceptional customer service to stakeholders for questions and concerns.

+ Responsible for all Medicare, Medicaid, and Case Management insurance denials processing as applicable to assigned area(s).

+ Responsible for all insurance appeals and works with appropriate stakeholders to ensure completion as applicable to assigned area(s).

+ Serves as point of contact for quotes, equipment authorization, etc. as applicable to assigned area(s).

+ The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job. Not all of the duties may be assigned to a position.

Maintains regular and consistent attendance as scheduled by department leadership.

Shift:

Day Shift - Variable Hours (United States of America)

Logan Health operates 24 hours per day, seven days per week. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

PRN positions (also referred to as Casual, As Needed, or Per Diem) at Logan Health offer flexibility and are designed to provide coverage during busy periods, employee absences, and vacations, making them an excellent opportunity to support the team as needed. PRN employees can participate in a matching 401(k) plan and have access to the Employee Assistance Program. Additionally, they may qualify for hourly differential pay for certain shifts or hours, offering extra compensation based on department-specific scheduling needs. Pay rates and scheduling practices may vary by department.

Notice of Pre-Employment Screening Requirements

If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes:

+ Criminal background check

+ Reference checks

+ Drug Screening

+ Health and Immunizations Screening

+ Physical Demand Review/Screening

Equal Opportunity Employer

Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.