Advanced Medical Billing & Denials Specialist

Community Health Systems, Inc.; United States; On-site; USD 48,000 - 68,000; Full time

Job summary

Community Health Systems, Inc. is seeking a Billing Specialist II to manage and audit insurance claims, rebill denied claims, and correct billing discrepancies within the electronic claims environment.

The role requires advanced knowledge of billing procedures, coding standards, and third-party payer requirements, and includes mentoring junior staff and ensuring timely, compliant submissions across departments.

Qualifications

• HS Diploma or GED required.
• Associate degree preferred in a related field (Business, Healthcare Administration, Medical Billing).
• 2–4 years of experience in medical billing, insurance claims processing, or revenue cycle operations required.
• Experience with hospital or physician billing, payer policies, and electronic billing systems preferred.

Responsibilities

• Processes and submits insurance claims via electronic and paper billing systems, ensuring accuracy and compliance.
• Reviews patient demographics, balances, and insurance information prior to claim generation and makes corrections.
• Identifies and resolves claim errors, denials, and rejections, rebilling within required timeframes.
• Monitors electronic billing processes, ensures successful claim downloads and timely follow-up on failures.
• Audits and assembles billing documentation, ensuring proper reimbursement and accuracy of claims.
• Demonstrates proficiency in revenue codes, HCPCS, CPT, UB-04, and CMS-1500 guidelines.
• Responds to payer inquiries with resolutions within two business days or escalates as needed.
• Maintains knowledge of third-party billing regulations and payer requirements to improve efficiency and compliance.
• Mentors and trains junior billing staff; collaborates with patient access, revenue cycle, and coding teams to prevent errors.

Skills

Advanced understanding of claim filing

Claims management systems

Coding knowledge HCPCS CPT

Denial management experience

Mentoring junior staff

MS Office & EHR proficiency

Strong communication

Education

Associate Degree in Business/Healthcare Admin/Medical Billing

H.S. Diploma or GED

Tools

Microsoft Office Suite

Job description

Community Health Systems, Inc. is seeking a Billing Specialist II to manage and audit insurance claims, rebill denied claims, and correct billing discrepancies within the electronic claims environment.

The role requires advanced knowledge of billing procedures, coding standards, and third-party payer requirements, and includes mentoring junior staff and ensuring timely, compliant submissions across departments.