Billing Specialist

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Oversee daily billing activities to ensure claims are accurate, timely, and clean.

• Assess claims and address daily billing claim adjustments.

• Ensure adherence to insurance billing policies and regulations.

• Maintain and update payer-specific split billing requirements within the team crosswalk.

• Submit appeals via payer portals and offer insights to the internal team.

• Import claims from the host system into the claims processing system as necessary.

• Review and resolve claims that are pending due to edits.

• Accurately prepare and submit claims for patient services.

• Examine patient accounts and reconcile payments with secondary payers.

• Analyze remittance advice and confirm that payments are recorded accurately.

• Address outstanding balances prior to filing with secondary payers.

• Ensure that billing and collection practices are in compliance with CMS regulations, HIPAA, and company policies.

• Keep precise claims records and documentation in patient account systems.

• Achieve assigned daily productivity and quality benchmarks.

• Collaborate with patient financial services, finance, and billing departments on account matters and disputes.

• Support management in maintaining or reducing accounts receivable days while enhancing cash flow.

⛳️ Requirements

• Demonstrated experience in third-party insurance billing, collections, or patient accounts, ideally in a healthcare environment.

• Thorough understanding of billing codes, guidelines, and regulations.

• Familiarity with electronic health record (EHR) systems, billing software, and remittance advice processing.

• Excellent communication skills, capable of explaining Medicare billing details and effectively addressing patient concerns.

• Ability to manage sensitive information while upholding confidentiality per HIPAA regulations.

• Detail-oriented with strong organizational abilities and the capacity to manage multiple accounts concurrently.

• Problem-solving skills related to billing discrepancies and denied claims.

• Experience with payer portals, client systems, and clearing house requirements.

• 3-5 years of experience as a primary biller within a hospital Business Office.

• Knowledge of medical terminology, ICD-10, CPT, DRG, and third-party insurance payer guidelines is preferred.

• High school diploma or equivalent; additional training in medical billing is advantageous.

• Reliable internet connection, quiet dedicated workspace, and necessary office equipment.

• Ability to communicate daily with team members, management, and clients via email, phone calls, video meetings, and collaborative tools.

🏝️ Benefits

• Comprehensive health and wellness benefits including medical, dental, vision, life insurance, and both short and long-term disability coverage.

• Health Savings Account (HSA) with employer contributions.

• Flexible spending accounts for healthcare and dependent care.

• Access to a wellness platform with premium incentives.

• Employee assistance support services.

• Optional supplemental plans such as accident, critical illness, hospital indemnity, and child disability insurance.

• Generous and flexible paid time off options.

• Company-paid holidays.

• 401(k) plan with discretionary employer matching opportunities.

• Opportunities for professional development.

• Company-issued equipment provided.