Billing Specialist

CHS Career Site; Birmingham (AL); On-site; USD 42,000 - 56,000; Full time

Job summary

CHS Career Site seeks a Billing Specialist II to manage complex billing processes and maximize collections. You will be the primary liaison for insurance payers, performing in-depth research to resolve issues and ensure accurate claims processing.

You will train staff, support audits, and ensure compliance with payer regulations and company policies while maintaining confidentiality and HIPAA standards.

Qualifications

• 2–4 years in medical billing, insurance claims processing, or revenue cycle management.
• 1–3 years in collections and insurance reimbursement.
• 0–1 years of Medicare experience preferred.

Responsibilities

• Serve as the primary contact for insurance companies, payers, and patients on billing inquiries and claim resolution.
• Review and process insurance claims, ensuring timely submission and payer guideline compliance.
• Identify and resolve credit balances, reclassify revenue, and process adjustments per coding policies.
• Review claim edits in EHR/PM systems (Athena, Cerner, Ingenious Med).
• Research and resolve claim denials and rejections; identify trends and apply corrective actions.
• Monitor vendor/payer audit trails and address discrepancies; submit secondary claims as needed.
• Maintain up-to-date knowledge of payer guidelines and HIPAA requirements.
• Assist in staff training on billing updates and maintain reference materials.

Skills

Healthcare billing

Payer communications

Revenue cycle management

Denials resolution

HIPAA compliance

Audit support

Staff training

Education

CPB - Certified Medical Biller

CMIS - Certified Medical Insurance Specialist

Tools

Athena

Cerner

Ingenious Med

Job description

Job Summary

The Billing Specialist II is responsible for managing complex billing functions, ensuring timely and accurate claims processing, and resolving issues related to insurance payments and account balances. This position serves as the primary contact for insurance companies and other payers, performing in-depth research to facilitate claim resolution and maximize collections. The Billing Specialist II also supports team training, assists with audits, and ensures compliance with payer regulations and company policies.

Essential Functions

• Serves as the primary point of contact for insurance companies, payers, and patients regarding billing inquiries and claim resolution.
• Reviews and processes insurance claims, ensuring timely submission and compliance with payer guidelines.
• Identifies and resolves credit balances, reclassifies revenue, and processes adjustments according to transaction coding policies.
• Reviews and corrects claim filing edits in electronic health record (EHR) and practice management systems (e.g., Athena, Cerner, Ingenious Med).
• Researches and resolves claim denials and rejections, working proactively to identify trends and implement corrective actions.
• Monitors and works vendor/payer audit trails, submitting secondary claims and addressing discrepancies as needed.
• Maintains up-to-date knowledge of federal, state, and payer billing guidelines, utilizing payer websites for claims follow-up.
• Assists in training staff and providers on billing updates, maintaining a centralized electronic repository for reference materials.
• Ensures proper billing and collection procedures in collaboration with management, clinic staff, and coding teams.
• Maintains confidentiality and ensures compliance with HIPAA regulations and company policies.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• 2-4 years of experience in medical billing, insurance claims processing, or revenue cycle management required
• 1-3 years in collections, knowledge of third party billing, and insurance reimbursement required
• 0-1 years of experience with Medicare preferred

Knowledge, Skills and Abilities

• Advanced knowledge of medical billing processes, insurance claim procedures, and payer policies.
• Strong understanding of revenue cycle management, including insurance reimbursement and claim adjudication.
• Proficiency in electronic health records (EHR) and practice management systems.
• Ability to analyze and resolve complex billing issues, including denials and payment discrepancies.
• Strong communication and problem-solving skills to interact with patients, providers, and payers.
• Ability to train and mentor team members on billing best practices.
• Detail-oriented with the ability to meet deadlines and manage multiple priorities.
• Working knowledge of HIPAA regulations and data confidentiality requirements.

Licenses and Certifications

• CPB- Certified Medical Biller issued by AAPC preferred or
• Certified Medical Insurance Specialist (CMIS) issued by PMI preferred