Billing Specialist

Prospect Infosys Inc; Nashville (TN); On-site; USD 41,000 - 55,000; Full time

Job summary

Prospect Infosys Inc. in Nashville, TN seeks a Billing Operations specialist to manage TennCare billing, payments, and reporting. The role emphasizes billing accuracy, revenue cycle support, and process improvements within standard business hours.

The ideal candidate has healthcare billing experience, strong Excel skills, and the ability to work independently while handling multiple priorities. This is a 1099 contract offering $35/hr.

Qualifications

• Experience in healthcare billing, Medicaid, or healthcare revenue cycle operations.
• Claims processing or encounter management.
• Microsoft Excel (intermediate level).
• Investigating billing discrepancies.
• Process improvement or workflow analysis.
• Data validation and quality assurance.
• Learning multiple software systems.
• Following detailed written procedures.
• Working independently while managing competing priorities.

Responsibilities

• Enter TennCare encounters into PTBMIS accurately and on time.
• Post payments, write-offs, and maintain revenue tracking.
• Update billing addresses and provider information; maintain HIPAA compliance.
• Prepare monthly billing reports and supporting documentation.
• Provide operational billing support to ensure continuity of services.
• Research billing discrepancies, payment issues, and claim denials; identify root causes.
• Document manual workarounds and standard operating procedures; support testing for new processes.
• Collaborate with laboratory staff, fiscal administration, procurement, informatics, and external stakeholders to resolve billing issues.

Skills

Medical billing

Claims processing

Excel (intermediate)

Billing discrepancy investigation

Process improvement

Data validation

Multiple software systems

Written procedures

Independent work

Job description

Rate: $35/hr. on 1099

Primary Responsibilities

Billing Operations (approximately 60%)

• Key TennCare encounters into PTBMIS accurately and within established timelines.
• Post payments, write-offs, and maintain revenue tracking.
• Update billing addresses and maintain provider information.
• Maintain HIPAA compliance and confidentiality standards.
• Prepare monthly billing reports and supporting documentation.
• Provide operational billing support to ensure continuity of services.

Revenue Cycle Support and Issue Resolution (approximately 20%)

• Research billing discrepancies, payment issues, claim denials, and reconciliation differences.
• Identify root causes of billing errors and recommend corrective actions.
• Review billing trends and identify recurring issues impacting reimbursement.
• Document manual workarounds and standard operating procedures.
• Perform reconciliations between billing activity, remittances, and financial reports.
• Monitor billing timelines to support timely filing requirements.

Billing Process Improvement (approximately 20%)

• Evaluate current billing workflows and identify opportunities for automation.
• Support implementation planning for a future third-party billing solution.
• Participate in workflow mapping and documentation.
• Plan, coordinate, and execute testing, validation, and documentation for new billing processes, system enhancements, and future third-party billing solutions.
• Recommend efficiencies that reduce manual data entry and duplicate work.
• Develop and maintain process documentation and training materials.
• Participate in special projects supporting modernization of laboratory billing operations.
• Collaborate with laboratory staff, fiscal administration staff, procurement, informatics, and external stakeholders to resolve billing issues and support billing process improvements.

Knowledge, Skills, and Abilities

Preferred candidates will have experience with:

• Medical billing, Medicaid, or healthcare revenue cycle operations
• Claims processing or encounter management
• Microsoft Excel (intermediate level)
• Investigating billing discrepancies
• Process improvement or workflow analysis
• Data validation and quality assurance
• Learning multiple software systems
• Following detailed written procedures
• Working independently while managing competing priorities

Experience with any of the following is preferred but not required:

• Tennessee Medicaid (TennCare)
• Healthcare billing software
• State government financial processes

Desired Qualifications

• Experience in healthcare billing, medical office administration, finance, laboratory operations, or related field.
• Strong analytical and problem-solving skills.
• Excellent organizational and time management abilities.
• Ability to identify process improvements and recommend practical solutions.
• Strong written and verbal communication skills.
• High attention to detail with demonstrated accuracy.
• Ability to maintain confidentiality and handle sensitive information.

Work Schedule

This position is expected to work:

• Standard business hours (8:00 AM-4:30 PM with one-hour lunch)

Skills :