Billing Specialist

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

📋 Description

• Oversee daily billing operations to guarantee timely, precise, and clean claims submission.

• Evaluate claims and address daily claim edits effectively.

• Ensure adherence to insurance billing policies and regulations.

• Maintain specific billing requirements for payers and keep the team crosswalk updated.

• Submit appeals through payer portals and provide constructive feedback to the internal team.

• Import claims into the claims processing system as necessary.

• Accurately prepare and submit patient-service claims in accordance with third-party payer guidelines.

• Review patient accounts and reconcile payments with secondary payers.

• Analyze remittance advice to confirm accurate posting of payments.

• Resolve outstanding balances prior to submitting claims to secondary payers.

• Ensure compliance with CMS regulations, HIPAA, and company policies.

• Keep precise claim records and documentation within patient account systems.

• Meet daily productivity and quality benchmarks.

• Collaborate with patient financial services, finance, and billing departments to address account issues and disputes.

• Support management in reducing accounts receivable days and enhancing organizational cash flow.

⛳️ Requirements

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

• Comprehensive knowledge of billing codes, guidelines, and regulations.

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

• Excellent communication skills, capable of articulating Medicare billing specifics and resolving patient concerns effectively.

• Proficient in handling sensitive information while maintaining confidentiality in line with HIPAA regulations.

• Detail-oriented with exceptional organizational skills and the ability to manage multiple accounts concurrently.

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

• Experience with payer portals, client systems, and clearinghouse requirements.

• 3–5 years of experience as a primary biller in 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.

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

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

🏝️ Benefits

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

• Health Savings Account (HSA) with employer contributions.

• Flexible spending accounts for health care and dependent care.

• Access to a wellness platform offering premium incentives.

• Employee assistance support services.

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

• Ample and flexible paid time off options.

• Company-paid holidays.

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

• Opportunities for professional development.

• Company-issued equipment provided.