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The Business Office Specialist is responsible for daily activities of the central business office accounts receivable, including preparation, submission, and collection of insurance claims. This role also involves monitoring compliance with billing practices and resolving payer issues.
Candidates must have experience in hospital billing, collections, and Medicare and commercial health care insurance. The position requires the ability to analyze and resolve billing edits and adhere to compliance and regulatory rules.
Our hospitals provide high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve. The Business Office Specialist position is responsible for the daily activities of the central business office accounts receivable, which include the preparation, submission and collection of insurance claims, Medicare/Medicaid billing, third party payer billing, and payment posting. Must have: hospital billing, collections, Medicare and commercial health care insurance experience. Prepares, processes, and files accurate and timely insurance claims for all payer types in accordance with department policy and payer requirements. Analyzes, interprets, and resolves all billing edits to ensure claims are filed accurately within the payer's regulations and filing limits. Adheres to compliance and regulatory rules as mandated by CMS, state and federal regulations, payer contracts, and established department policies and procedures. Processes and monitors all refunds, adjustments, corrections, etc. Monitors compliance of proper billing practices in accordance with federal, state, local standards, guidelines, and regulations. Prepares end of day, month and year to comply with financial policy and procedures. Handles correspondence related to the billing of a claim for all lines of business, answers questions and updates accounts as necessary. Assists in cost containment development of the department within budgeted parameters; reviews bad debt activity. Accurately posts payments to Patient Accounts. Oversees monthly cash reconciliations and reporting. Updates and reviews all accounts to keep records up to date, follow up with payer on unpaid claims. Resolves denials, appeals, and other payer issues, works with hospital personnel when required. Authentic. Inspiring. Transformative. ClearSky Health and our affiliated Hospitals provide high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve. We value our employees’ skills, talents, and input. We believe in maintaining hospital environments where employees are: Valued Treated with dignity Respected Provided educational and training opportunities Recognized Rewarded ClearSky Health has plans to open medical rehabilitation hospitals at the following locations listed below. If you are interested in learning more, please email us and send your resume to jobs@clearskyhealth.com. Lakeshore (Cleveland), WI Lake City, FL Rockwall County, TX Eau Claire, WI
This job posting was last updated on 7/23/2025