Billing Specialist

Stellar Professionals; Nashville (TN); Hybride; USD 30 000 - 47 000; Plein temps

Résumé du poste

Stellar Professionals is seeking a TennCare Billing Specialist in Nashville, TN. The role focuses on maintaining TennCare billing operations, processing medical encounters, reconciling payments, and supporting revenue cycle modernization.

The position requires residency in Tennessee and offers hybrid work with on-site training. Monday–Friday, 8:00 AM–4:30 PM CST, with standard state background checks and a contract through late November 2027.

Qualifications

• Experience in medical billing and TennCare/Medicaid claims processing.
• Proficient in balancing and reconciling billing accounts and remittances.
• High-volume, accurate data entry and customer service.
• Intermediate-to-advanced Excel skills (formulas, data validation, tracking reports).
• Experience mapping workflows and validating software testing.

Responsabilités

• Enter TennCare medical encounters into PTBMIS accurately and on time; post payments and write-offs; maintain provider profiles.
• Research claim denials and billing discrepancies; document root causes and perform routine reconciliations.
• Support modernization efforts by evaluating lab billing workflows and updating SOPs and training guides.

Connaissances

Healthcare billing

Revenue cycle

Data entry

Attention to detail

Outils

Excel

PTBMIS

StarLIMS

Availity

Description du poste

We are seeking a detail-oriented TennCare Billing Specialist in Nashville, TN. This role maintains uninterrupted TennCare billing operations, processes medical encounters, reconciles payments, and supports long-term revenue cycle modernization. The specialist will work closely with laboratory billing staff, fiscal administration, informatics, and vendor partners to improve billing workflows, eliminate manual redundancies, and prepare for a modernized third-party billing platform.

Location: 630 Hart Lane, Nashville, TN 37216

Work Arrangement: Hybrid (On-site required during initial system training; eligible for hybrid work upon demonstrating independent system proficiency)

Residency Requirement: Candidate MUST be a current resident of Tennessee (or established resident in the local service area prior to start)

Role Type: Contract (11/09/2026 06/30/2027; Position expected to continue through November 30, 2027, contingent on funding)

Interview Process: Web Cam or In-Person Interview

Shift / Schedule: Monday Friday, 8:00 AM 4:30 PM CST (37.5 hours per week)

Background Verification: Requires standard state background verification (7-year criminal history, statewide county search, sex offender registry, global watch).

Key Responsibilities

• TennCare Billing Operations (60%): Key TennCare medical encounters into PTBMIS accurately and within strict filing deadlines; post payments and write-offs; maintain provider profiles; prepare monthly billing and revenue tracking reports.
• Revenue Cycle Support & Issue Resolution (20%): Research claim denials, billing discrepancies, and remittance differences; analyze root causes of billing errors; document manual workarounds and perform routine financial reconciliations.
• Billing Process Improvement & Modernization (20%): Evaluate laboratory billing workflows to identify automation opportunities; support system testing and user validation for future third-party billing platforms; update standard operating procedures (SOPs) and training guides.
• Compliance & Stakeholder Coordination: Maintain HIPAA data privacy standards; collaborate with laboratory staff, fiscal administration, procurement, informatics, and external state clearinghouses.

Required & Desired Qualifications

• Healthcare Billing & Revenue Cycle: Experience in medical billing, Medicaid/TennCare claims processing, healthcare revenue cycle operations, or laboratory office administration.
• Financial Reconciliation & Bookkeeping: Demonstrated proficiency in balancing/reconciling billing accounts, remittances, and ledger entries (4 6 years experience).
• Data Entry & Accuracy: 4 6 years of high-volume, accurate data entry, typing, and customer service.
• Software & Spreadsheets: Intermediate-to-advanced proficiency with Microsoft Excel (data validation, formulas, tracking reports) and healthcare billing systems.
• Process Improvement & QA: Experience investigating billing discrepancies, mapping workflows, and executing software testing/validation.
• Tennessee Residency: Must be a current resident of the State of Tennessee residing within the local service area.

Preferred Systems Experience

• Hands-on experience with state or laboratory billing systems, including PTBMIS, StarLIMS, Availity, or TennCare Medicaid billing platforms.
• Knowledge of state government financial and procurement processes.