Hospital Biling and Claims Follow-Up Specialist

Job Description

We are seeking a detail-oriented Hospital Billing and Claims Follow-Up Specialist to support hospital and health system clients. This position is responsible for billing corrected claims, resolving unpaid and denied accounts, and communicating with insurance payers to support accurate and timely reimbursement. The role focuses on payer follow-up and claim resolution and does not involve patient collections, eligibility verification, or preauthorization.

Key Responsibilities

· Prepare and submit hospital claims, including corrected claims, for multiple clients across multiple states and payer types.

· Research unpaid, underpaid, rejected, and denied claims using payer portals, electronic systems, and telephone follow-up.

· Identify root causes of claim issues and take appropriate action to support timely reimbursement.

· Prepare and submit appeals, reconsiderations, and supporting documentation when appropriate.

· Correct and reprocess claims in accordance with payer requirements, billing guidelines, and client procedures.

· Document account activity, follow-up actions, and claim status accurately in client and internal systems.

· Communicate professionally with payers, client contacts, and internal team members regarding claim resolution.

· Meet established productivity, quality, and turnaround-time expectations.

· Perform related administrative and clerical duties as assigned.

Qualifications

· Three or more years of hospital billing, claims follow-up, or revenue cycle experience preferred.

· Working knowledge of hospital billing requirements, claim forms, payer policies, denials, appeals, and reimbursement processes.

· Knowledge of medical coding concepts, including ICD-10-CM, CPT, HCPCS, modifiers, and their impact on claim accuracy and reimbursement, preferred.

· Experience with hospital revenue cycle and payer systems such as Epic, Oracle Health/Cerner, Quadax, Waystar, and Availity preferred.

· Strong analytical, critical-thinking, and critical thinking skills.

· Excellent written and verbal communication skills.

· High diligence and the ability to maintain accurate documentation.

· Ability to manage multiple priorities, work independently, and meet productivity and quality expectations.

· Proficiency with Microsoft Excel, Word, and web-based applications.

· Strong work ethic, professionalism, reliability, and willingness to learn.

Job Type: Full-time

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule

• 8-hour shift
• Monday to Friday

Preferred Experience

• Hospital Billing: 3 years (Preferred)
• Coding: Experience with ICD-10-CM, CPT, HCPCS, and modifiers (Preferred)

Shift availability:

• Day Shift (Required)

Work Arrangement

· Hybrid remote position based in Hudson, Ohio 44236.

· Ability to commute to the Hudson office as required.

Job Types: Full-time, Part-time

Pay: $22.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Hospital Billing: 3 years (Preferred)

Shift availability:

• Day Shift (Required)

Ability to Commute:

• Hudson, OH 44236 (Required)

Work Location: Hybrid remote in Hudson, OH 44236

Salary : $22 - $25