Job Description

About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

The Hospital Billing Clerical Specialist is responsible for supporting the billing and claims submission process by gathering required documentation, preparing claims for mailing, verifying payer mailing information, and maintaining accurate tracking records of all claims sent to insurance carriers and other payers. This role ensures timely and accurate claim submissions to support reimbursement and revenue cycle operations.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

This position is HYBRID in Kona, HI.

About this position:

Location: Onsite, NEAR Kona Community Hospital, (79-1019 Haukapila Street, Kealakekua, HI 96750)

Required Schedule: Monday - Friday, 7:30 AM - 4:00 PM

Competitive Hourly Salary PLUS a sign on BONUS!

This role offers an excellent opportunity to launch your career in the healthcare revenue cycle field, and we’re ready to train the right candidate.

Essential Duties and Responsibilities

• Gather, organize, and review supporting documentation required for claim submission, including medical records, itemized bills, authorization forms, and other payer-required documents.
• Verify that claim forms contain accurate payer names, mailing addresses, and other required information prior to submission.
• Prepare and assemble claim packets for mailing to insurance companies, government payers, third-party administrators, and other responsible parties.
• Maintain claim submission logs and tracking systems to monitor mailed claims and ensure timely follow-up.
• Document mailing dates, tracking numbers, and claim status updates in internal systems.
• Coordinate with Billing, Patient Financial Services, Medical Records, and other departments to obtain missing documentation.
• Research and resolve returned mail, incorrect payer addresses, and documentation deficiencies.
• Ensure compliance with organizational policies, payer requirements, HIPAA regulations, and confidentiality standards.
• Respond to inquiries regarding claim status and document submission history as needed.
• Assist with special projects, audits, and reporting related to claims processing and revenue cycle operations.
• Maintain accurate filing systems and electronic records of submitted claims and correspondence.

Qualifications

Education

• High School Diploma or equivalent required.
• Additional coursework in healthcare administration, medical billing, or business administration preferred.

Experience

• One (1) year of clerical, medical billing, healthcare administration, or related experience preferred.
• Experience working in a hospital, physician practice, or healthcare revenue cycle environment is a plus.

Knowledge, Skills, and Abilities

• Knowledge of medical billing processes and insurance claim requirements.
• Familiarity with Medicare, Medicaid, commercial insurance, and managed care payers preferred.
• Strong attention to detail and organizational skills.
• Ability to manage multiple priorities while meeting deadlines.
• Proficiency with Microsoft Office applications and healthcare information systems.
• Excellent written and verbal communication skills.
• Ability to maintain confidentiality and handle sensitive patient information.
• Strong problem-solving and follow-up skills.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.