Your experience in medical billing is enhanced by your compassionate, service-oriented approach. At Legacy, we value both skill and empathy—ensuring our team members can grow professionally while building meaningful connections with patients and colleagues. If you're looking to be part of a healthcare organization that truly strives to make life better for others, we encourage you to consider this opportunity as a Patient Business Services Float.

This is a hybrid-remote position available to residents of Oregon or Washington only. The role follows a rotating schedule requiring occasional on-site work at our NW 31st Business Office. For the remainder of the schedule, work may be completed remotely.

All new hires are required to visit a designated Legacy Health office in Portland, Oregon prior to their start date to complete a new hire health assessment and onboarding paperwork. Initial training and orientation for this position may be conducted on-site before transitioning to the hybrid schedule.

Under general supervision, the PBS Float provides flexible staffing support within the Professional Billing and Follow-Up team, covering a variety of roles across Patient Business Services (PBS). These roles include, but are not limited to: PBS Support, Biller 1, 2, Biller Follow-up Specialist, and Lead, Billing Editor and Account Follow-up Specialist 2. May be hybrid depending on department staffing model.

Billing (Biller 1/Biller 2/Follow-up Specialist)

• Edits claims to ensure accuracy and completeness, applying knowledge and understanding of Universal billing rules, regulations and claim form requirements.
• Reviews and completes necessary forms to ensure accurate billing.
• Ability to review specialty contracts and high dollar accounts require many extra claim forms, knowledge of special requirements, adjustments, and matrix reviews to pay physicians:
• Complies with specialty coding requirements for UB04 and CMS-1500’s for Government and Commercial payer requirements.
• Complies with health plan requirements for bundling of charges and applies charge modifiers including value codes, occurrence span codes, condition codes and place of service as appropriate. 
• Combines inpatient overlap accounts, ancillary outpatient services within 72 hours of an inpatient admit.
• Re-assigns claims held in editor to ensure re-routing to appropriate biller.

Billing Editor

• Applies knowledge of Medicare/Medicaid regulations correctly when determining whether accounts require combining or adjustment.
• Reviews inpatient and outpatient accounts within 3 days post discharge to ensure charges are accurate before billing.
• Facilitates patient class changes in conjunction with Utilization Management reviews/requests. Applies inpatient room, observation and extended stay charges, as appropriate, prior to billing.
• Completes corrections on auditor, donor, and cosmetic split accounts.
• Researches and resolves billing issues (debit/credit adjustments including package price adjustments, charges to transfer any incorrect codes or information) on pending accounts.
• Reviews reports for DRG updates, preadmissions, cancellations, corporate accounts, late charges, etc. and make necessary transactions daily.
• Acts as a resource for all departments on charge/adjustment procedures according to LHS policy.

Account Follow-Up Specialist 2 (Denial Management)

• Resolves delinquent payment issues of complex (high dollar and specialty) accounts requiring advanced knowledge of multi-payor system. 
• Investigates and evaluates patient account information, medical records and bills, billing and reimbursement regulations. 
• Analyzes each account and using independent judgment decides how to best proceed with followup to optimize reimbursement.
• Removes barriers to processing claims. 
• Negotiates financial arrangements and individual contracts with third-party payors. 
• Rebills, transfers payments, requests refunds or adjusts misapplied payments as necessary.
• Understands and follows Legacy procedures for writing off balances and adjustments.

Additional Duties

• May serve as backup for other PBS roles or departments.

• May generate or work from various payer-specific reports.

• May assist with training or serve as Biller 2 Lead.

• Maintain professionalism in all communication, including phone, email, and in-person inquiries.

Education:

• High school graduate or equivalent.

Experience:

• Two years of directly applicable healthcare clerical experience or applicable billing, credit/collections experience.

Skills: 

• Demonstrated familiarity with specialty billing procedures and contracts. 
• Attention to detail: Accuracy in data entry and billing processes. 
• Demonstrated knowledge of multi-payor systems.  
• Demonstrated knowledge of billing/collection rules and regulations. 
• Knowledge of online systems for eligibility and status review of claims preferred. 
• Technical Proficiency: Familiarity with billing software and electronic medical records including Microsoft suite products and 10 key proficiencies.  
• Knowledge of medical terminology preferred. 
• Problem Solving: Ability to resolve billing issues and handle denied claims. Ability to work efficiently with minimal supervision, exercising independent judgment within stated guidelines. 
• Demonstrated effective interpersonal skills which promote cooperation and teamwork. 
• Organization Skills: Efficiently manage multiple tasks and deadlines.  
• Communication skills: excellent verbal and written communication skills.  
• Ability to adapt to change. 

Our Legacy is good for health for Our People, Our Patients, Our Communities, Our World. Above all, we will do the right thing.

If you are passionate about our mission and believe you can contribute to our team, we encourage you to apply—even if you don't meet every qualification listed. We are committed to fostering an inclusive environment where everyone can grow and succeed.

Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law.

To learn more about our employee benefits click here: https://www.legacyhealth.org/for-health-professionals/careers/benefits