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Community Health Systems · 1 month ago

Billing Specialist - Remote

United States

Full-time

Remote

New Grad, Entry Level

0+ years exp

Community Health Systems is one of the nation’s leading healthcare providers, committed to helping people get well and live healthier. The Billing Specialist I is responsible for processing, auditing, and submitting primary and secondary insurance claims, ensuring accuracy, compliance, and timely reimbursement.

Health CareHospital

Responsibilities

Processes and submits primary and secondary insurance claims accurately and in a timely manner, ensuring compliance with payer guidelines and regulatory requirements

Reviews and resolves claim errors, rejections, and denials, making necessary corrections and resubmitting claims as needed

Demonstrates working knowledge of billing forms, including UB-04, CMS-1500, or state-specific billing forms, ensuring claims are submitted with the appropriate documentation

Audits claims for accuracy, checking for duplicate charges, overlapped accounts, and missing information before submission

Investigates and processes rebill requests, verifying claim accuracy and making necessary updates per facility or coding liaison direction

Maintains knowledge of billing regulations, payer policies, and electronic submission guidelines, staying up to date with federal, state, and local billing requirements

Utilizes electronic billing systems to analyze, research, and transmit claims, ensuring proper documentation of actions taken in the collection system

Monitors and reports charging or edit trends, collaborating with internal teams (such as coding, patient access, and ancillary departments) to improve billing accuracy

Performs daily balancing tasks using SSI and other billing systems, escalating unresolved issues or billing delays to the Billing Services Manager

Communicates professionally with payers, facility representatives, and internal teams, ensuring efficient issue resolution and proper follow-up on outstanding claims

Performs other duties as assigned

Maintains regular and reliable attendance

Complies with all policies and standards

Qualification

Medical billingInsurance claims processingElectronic claims systemsBilling softwareAttention to detailMicrosoft Office SuiteEHR systemsRegulationsCPB certificationCommunication skillsProblem-solving skillsOrganizational skills