EDUCATION/QUALIFICATIONS

· Required: High School Diploma or equivalent

· Preferred: Associate’s Degree

EXPERIENCE:

· Required: Minimum 1–3 years of experience in hospital billing, insurance follow-up, or medical collections

· Required: Understanding of UB-04 and 1500 billing, payer claim processing, and denial management.

· Required: Familiarity with Medicare, Medicaid, and commercial payer guidelines.

· Required: Working knowledge of EOBs, remittance advice, and claim adjudication.

SKILLS

· Strong attention to detail and analytical skills.

· Excellent communication and negotiation abilities.

· Proficient in hospital billing systems and Microsoft Office (Excel, Word, Outlook).

· Ability to prioritize and manage multiple tasks independently in a remote setting.

At Fairfield Memorial Hospital, we seek highly skilled, compassionate employees to continue our healing mission: to positively influence the health of those we serve. Our team is committed to providing the best possible patient experience. FMH is also committed to providing our team members with an environment that allows them to do their best work while providing opportunities for ongoing professional development.

NATURE OF WORK

The Hospital Insurance Collections Specialist is responsible for managing and resolving outstanding insurance balances for hospital services. This position ensures timely and accurate follow-up on unpaid or denied claims, identifies and corrects billing issues, and works closely with payers, patients, and internal departments to secure maximum reimbursement in compliance with federal, state, and payer regulations.

Key Responsibilities

· Review and analyze aged insurance accounts receivable (A/R) to identify unpaid or underpaid claims.

· Contact insurance carriers via phone, portals, or correspondence to resolve claim issues and secure payment.

· Investigate claim denials, rejections, and payment discrepancies; prepare and submit corrected claims or appeals as needed.

· Document all collection activity in the patient accounting system accurately and timely.

· Coordinate with billing, coding, and registration departments to correct claim errors or obtain missing information.

· Monitor payer trends and report recurring issues to management.

· Verify payer policies and follow payer-specific guidelines for claim submission and appeals.

· Ensure compliance with HIPAA, hospital policies, and all regulatory requirements.

· Maintain productivity and collection goals as assigned.

· Perform other related duties as assigned to support the business office and revenue cycle.
 

BENEFITS

· 403(b) Retirement Plan

WORKING CONDITIONS

· Remote Work Option: Position may be eligible for remote work from a home office environment, subject to department approval. Requires reliable high-speed internet access and a secure, distraction-free workspace compliant with HIPAA privacy standards when working remotely.

· Schedule: Regular business hours apply, with flexibility as determined by department needs.

· Tools & Communication: Frequent use of computer, telephone, and web-based applications is required.
 

WHAT FMH HAS TO OFFER When working with FMH, you can expect salary and benefit package competitively placed within the local market, including medical, dental, vision, life, disability, retirement, with company match, referral bonuses and more.

FMH is a drug-free workplace. As a condition of employment, all hires are required to pass a pre-employment drug test.

FMH believes that Our People are our strongest tool for success. We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status or on the basis of disability. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, or gender identity.