Hospital Billing & Claims Appeal Specialist

Location: On Site - Lafayette, Louisiana, United States

Salary: $50,000+ depending on experience

Skills: Hospital Billing, Claims Appeals, Post-Acute Setting, Payor Contract Interpretation, MS Excel

About the Health Care Company / The Opportunity:

This is an exciting opportunity to join a dynamic team in the Health Care industry dedicated to making a meaningful impact in the lives of patients every day. As a Hospital Billing & Claims Appeal Specialist, you will play a pivotal role in supporting operations within a post-acute care environment while growing your career in a collaborative and supportive setting. This on-site role offers a chance to contribute to integrated healthcare management in Lafayette, Louisiana, and be part of a mission-driven organization committed to excellence in patient care and employee development.

Responsibilities:

• Manage patient account billing, including preparing and mailing monthly statements and processing electronic billing submissions.
• Oversee fiscal year-end cost reporting and ensure accurate documentation for billing records.
• Support the billing team and corporate office in identifying and resolving incorrect contracted payments from managed care payors.
• Write, file, and follow up on appeals regarding claim denials in compliance with payor contract guidelines.
• Assist billing specialists in obtaining necessary documentation for appeals and maintaining appeal timelines.
• Collaborate effectively with colleagues to achieve departmental objectives and provide excellent customer service.
• Interpret and explain complex information related to billing and claim appeals to internal and external stakeholders.
• Utilize strong organizational and time management skills to handle multiple tasks and deadlines efficiently.

Must-Have Skills:

• 2-3 years of hospital billing, collections, or accounting experience in a health care setting.
• Extensive experience with claim appeals and billing in the post-acute or long-term acute care (LTAC) setting.
• Ability to interpret payor contracts for appropriate appeal rights and regulatory compliance.
• Strong knowledge of MS Word and Excel for billing operations and reporting.
• Exceptional communication, organizational, analytical, and problem-solving skills.
• Diplomatic and clear articulation of complex information in written and verbal communications.

Nice-to-Have Skills:

• Prior experience supporting billing specialists and managing multiple appeal workflows.
• Background in patient account billing in multi-site or multi-facility health systems.
• Experience with Employee Stock Ownership Plan (ESOP) organizations.
• Familiarity with a variety of managed care payors and electronic submission systems.
• Ability to work as a self-starter with strong attention to detail under tight deadlines.