The Inpatient Billing & Collections Specialist serves as a key member of the Central Business Office team and is responsible for managing inpatient accounts receivable, billing follow-up, collections, denial resolution, and reimbursement activities for aged accounts. This position ensures claims are billed accurately and timely, account documentation supports reimbursement expectations, and all collection activities are completed in accordance with payer contracts, Federal and State regulations, and company policies.
The ideal candidate will have strong knowledge of hospital billing procedures, insurance follow-up, and revenue cycle operations with the ability to manage a high-volume workload while maintaining attention to detail and professionalism.
Essential Duties & ResponsibilitiesRespond to incoming telephone calls and correspondence related to patient accounts and route inquiries appropriately.Review admission and billing documentation to confirm claims are accurate and supported according to payer contract guidelines.Communicate with insurance companies, facilities, and internal departments to obtain additional information necessary for claim resolution and timely reimbursement.Verify claims have been billed, received, and processed appropriately by payers.Maintain organized and complete patient financial files, including claims, EOBs, appeals, and correspondence.Research and resolve denied, rejected, or unpaid claims by coordinating rebills and obtaining required payer information.Follow up on unpaid claims beyond contractual payment timelines to maximize reimbursement.Monitor electronic claim submissions to ensure claims are accepted without rejection.Work assigned aging accounts daily while documenting all collection efforts and account activity thoroughly.Post payments, adjustments, and patient responsibility balances accurately and timely.Process adjustments and account corrections within established departmental timelines.Prepare account summaries and updates for aged accounts and monthly Accounts Receivable review meetings.Coordinate with facility personnel to obtain documentation needed for appeals and payment resolution.Identify and escalate reimbursement concerns, payer trends, or process issues that may impact collections.Identify and process credit balances and refund requests in accordance with Federal, State, and payer requirements.Assist with audit preparation and maintenance of complete patient account records.Support additional Central Business Office functions and team initiatives as assigned.QualificationsEducationHigh school diploma or equivalent requiredAssociate degree or additional college coursework preferredExperienceMinimum of one (1) year of experience in a hospital business office, healthcare billing, or medical collections environment requiredExperience with inpatient billing and insurance follow-up preferredKnowledge of Medicare, Medicaid, Managed Care, and commercial insurance reimbursement practices preferredSkills & CompetenciesStrong understanding of medical billing and collections processesKnowledge of insurance claims, denials, appeals, and reimbursement guidelinesExcellent organizational and time management skillsAbility to manage a high-volume workload and meet productivity expectationsStrong written and verbal communication skillsDetail-oriented with strong analytical and problem-solving abilitiesProficiency with electronic medical records and billing systemsAbility to work independently and collaboratively in a team environmentWhy Join Us?Competitive compensationComprehensive benefits packageOpportunity to grow within a healthcare organizationCollaborative and supportive work environmentMeaningful work supporting patient care operationsPOSITION SUMMARY:
The Maintenance Staff assists the Director Plant Ops to ensure maintenance of facility/hospital physical plant operations and equipment are being maintained and inspected as required.
JOB-SPECIFIC RESPONSIBILITIES:
Your exceptional skills
The role requires a working knowledge of maintenance principles, theories, and operations. Knowledge of basic hand and power tools. Good oral and written communications skills – including reading and writing skills at a high school graduate level. Ability to work with peers in a team situation. Individuals may not perform all these duties, or may perform additional, related duties not listed here:
• Troubleshoots and repairs a broad variety of hospital equipment and systems.
• Performs preventive maintenance on hospital equipment and systems.
• Operates a broad variety of hospital equipment and systems.
• Performs construction tasks to prepare the hospital for furnishings, equipment, and systems.
• Responsible for maintaining parts and material inventory to ensure maintenance and repair functions can be completed.
• Pursues educational improvements and provides training on procedures, equipment, and system operations.
• Serves as a maintenance resource to monitor hospital equipment and systems' operation status and condition.
• Works to ensure the department provides high-quality, cost-effective maintenance support for the hospital.
• Serves as a maintenance source to monitor equipment and systems' operating status and condition.
• Responds to customers’ comments or informal complaints about hospital systems or operations and has a recommendation to the supervisor within 24 hours.
• Maintains and completes maintenance journals, logs, and time sheets daily.
• Performs air balance, water, steam, refrigerant, and temperature control measurements/adjustments on systems to achieve optimum performance. Measures air velocity, pressure, flow, and temperature
Skills
Demonstrated skills in one of the following areas and some working knowledge of the remaining required:
• HVAC equipment
• Heating hot water system
• Electrical and power distribution
• Refrigeration equipment
• Construction methods
• Plumbing
• Mechanical maintenance
• Ability to read and interpret blueprints, schematics, and writing diagrams
• Working knowledge of maintenance principles, theories, and operations
• Knowledge of basic hand and power tools
• Good oral and written communication, including reading and writing skills, a high school graduate level
• Ability to work with peers in a team situation
Keywords
Maintenance, Facilities
• Consistently within 10% (ten percent) accuracy.
• Predicts and adjusts the total system to maintain proper performance after any air, water, temperature, or pneumatic changes are made.
POSITION QUALIFICATIONS:
EDUCATION:
Minimum of High School diploma or equivalent
EXPERIENCE:
Minimum two (2) years related building maintenance experience with emphasis on maintenance, repair, and semi-skilled craftsman of various building trades, including plumbing, electrical, and painting.
Must be knowledgeable of building codes, licensing standards, DNV, and ADA guidelines.
LICENSURE/CERTIFICATION:
None required
Basic computer skills required
POSITION SUMMARY:
The maintenance staff assists the corporate director of facilities in ensuring that facility/hospital physical plant operations and equipment are being maintained and inspected as required.
JOB SPECIFIC RESPONSIBILITIES:
Maintains facility in good repair to ensure a safe environment.Ensures a clean and safe environment in all exterior areas of the facilityReports all unsafe/hazardous conditions, defective equipment, etc. to the safety supervisor immediately.Demonstrates problem-solving and problem prevention skills in the areas of maintenance and safety.Demonstrates ability to sort the soiled linen using appropriate infection control personal protective equipment.Demonstrates knowledge of cleaning chemicals and the proper use for each chemical.Demonstrates flexibility in scheduling in order to meet the staffing needs of the department.Assists housekeepers with terminal cleaning as needed.Assists housekeepers with the buffing and waxing of the floors as needed.Performs the preventative maintenance (PM’s) on the Air handlersPerforms inspections of the water heaters Performs inspections of the chilled water pumpsPerforms inspections of the elevatorPerforms inspections of the exhaust fansPerforms inspections and run load test on the generatorPerforms inspections of the hot water pumpsPerforms inspections of the isolation exhaust fans on a daily basisPerforms inspections in isolation roomsPerforms inspections of the medical air systemPerforms inspections of the air coolers and freezersParticipate in EOC rounds and repair deficiencies that relate to maintenance Perform Exit and Stairwell lightingPerform inspection on a monthly basis of the Fire extinguishersPerform fire drills as requiredEnsures that Back flows are inspected as requiredEnsures that grease trap is clean as scheduledEnsures that the fire alarm system is working properlyPerform inspection of the fire dampersInspects fire doors on a daily basisParticipates in the safety committeeParticipates in Emergency preparednessEnsure proper water temperaturesAll other duties as assignedPOSITION QUALIFICATIONS:
EDUCATION:
Minimum of High School diploma or equivalentEXPERIENCE:
Minimum two (2) years related building maintenance experience with emphasis on maintenance, repair and semi-skilled craftsman of carious building trades, including plumbing, electrical and painting.Must be knowledgeable of building codes, licensing standards and ADA guidelines.LICENSURE/CERTIFICATION:
None requiredBasic computer skills requiredPOSITION SUMMARY:
The System Coordinator, Patient Accounts II serves as the secondary gatekeeper for the Nexus Health Systems Business Office. This position is responsible for handling Central Business Office incoming telephone calls, correspondence, and patient account documentation for accounts assigned aged 61+. Position confirms that the patient financial folder contains the completed and appropriate billed claims; billing account documentation supports the expected reimbursement for timely and accurate collections per the contract. The position creates Federal and State mandated reporting.
JOB-SPECIFIC RESPONSIBILITIES:
1. Responds to telephone calls, working with those that are routine in nature, or routing the appropriate staff member as calls occur.
2. Confirms admission documentation from the facilities and the CBO biller; the claim documentation is accurate compared to the assigned payer per contract guidelines.
3. Communicates internally/externally to obtain additional patient information to collect timely and per the contract.
4. Confirms claims were billed and received for accounts assigned.
5. Confirm patient financial folders are assembled and maintained sequentially. Confirm claims were billed and correspondence matches to the appropriate patient account when filing completed EOBs.
6. Requests rebill claims as payers identify no claim on file or claim denied by providing appropriate requests to billers. Obtain complete information from the payer to rectify and allow claims to be billed correctly and timely via paper and/or electronic to have claims reimbursed timely.
7. For claims submitted timely and accurately that remain unpaid past the contract requirements must be pursued for 100% of total charges.
8. Confirm claims submitted electronically have been received with no rejections.
9. Claims rejected or not confirmed received are to be requested from the biller immediately. Provide information to ensure the claim is submitted correctly to the biller. Mandatory to work and collect on estimated 35 accounts per day. Account documentation is required.
10. Document payment, adjustment, patient responsibility daily as EOBs are received or verified electronically.
11. Submit Adjustments within 24 hours of receipt of posting payments or receiving EOBs. The claim must be resolved within the same month the payment is posted.
12. Document collection efforts taken on each account billed for claims aged 60+ days. All actions taken must be noted. Collections or billing confirmation can be obtained via phone call to the payer, lockbox, or online.
13. Mandatory to work 35+ accounts from aging daily.
14. Prepares and summarizes accounts actions for accounts aged 90+ for monthly CEO AR call.
15. Responds to correspondence within 24 hours from the date of receipt.
16. Communicates with facility personnel to coordinate patient documentation required to appeal or rectify payments.
17. Forward denial correspondence to the appropriate staff to assist with appeals.
18. Files all bills, appeals, communication to each patient/claim appropriately in the patient chart.
19. Identify credit balances monthly and prepare adjustments to refund appropriate credits before the end of each month for Federal and State-funded agencies. (Medicare, Managed Medicare, Medicaid, Managed Medicaid, DARS).
20. Credit balances on non-Federal or State Funded claims are prepared on the adjustment sheets and forwarded to Refund Pending, waiting for refund requests from payers.
21. Work accounts assigned on aging twice per month. Follow-up is required every 7-14 days, depending on how the claim was billed.
22. Pull paid accounts monthly from patient files to box and store. Confirm the file is complete and in order before boxing if the file is reviewed during any audit processes.
23. Identify any internal/external changes, processes, procedures, etc. that may create reimbursement issues.
24. Assists other CBO employees as necessary.
25. Performs all other duties as assigned.
POSITION QUALIFICATIONS:
EDUCATION:
• A high school diploma is required
• One to two years college preferred.
EXPERIENCE:
• Minimum of one (1) year of experience in a hospital business office setting, or at least one year of experience in the medical billing/collection field.
LICENSURE/CERTIFICATION:
• None required
