Billing Specialist I - REMOTE

Lensa; Sarasota (FL); Remote; USD 35,000 - 45,000; Full time

Job summary

A leading healthcare provider is seeking a Billing Specialist to manage insurance claims processing. The role involves accurate billing, compliance with regulations, and resolving claim issues. Ideal candidates will have a high school diploma and some experience in medical billing.

Qualifications

• Less than 1 year experience in a hospital or medical setting required.
• 1-3 years billing experience in a medical facility preferred.

Responsibilities

• Bills all primary and secondary insurance claims accurately.
• Ensures compliance with billing requirements and audits claims.
• Processes claim updates and resolves claim processing issues.

Skills

Proficiency in Word Processing

Spreadsheet

Email software

Education

H.S. Diploma or GED

Associate Degree

Job description

Lensa is the leading career site for job seekers at every stage of their career. Our client, Community Health Systems, is seeking professionals. Apply via Lensa today!

Job Summary

Processing claims via electronic claims management system by reviewing identified errors or rejections and resolving these issues appropriately. Responsible for completing requests for rebilling of denied claims.

Essential Functions

1. Bills all primary and secondary insurance claims in a timely and accurate manner.
2. Demonstrates working knowledge of all appropriate billing forms, UB04, 1500, or state-specified forms.
3. Demonstrates working knowledge of the electronic billing system, including understanding of edits and reports.
4. Ensures compliance with federal, state, local, and intermediary billing requirements, completing authorizations and notifying relevant personnel of missing or incomplete information.
5. Audits each bill/account for charges, duplications, and overlaps before billing, making necessary adjustments and documenting appropriately.
6. Resolves claim processing issues promptly by reviewing claim inventories and taking appropriate action.
7. Ensures accurate and complete clean claim submission for both paper and electronic claims in a timely manner.
8. Maintains current knowledge of billing methods, laws, and hospital rules related to insurance claims and electronic submissions.
9. Completes SSI daily balancing and communicates issues or delays to the Billing Services Manager.
10. Communicates billing trends to the manager and provides education to other departments to reduce errors.
11. Performs under tight deadlines.
12. Maintains knowledge of government rules and regulations.
13. Uses necessary technology, including SSI, phone tech, PULSE/DAR, eligibility tools, claim status, and scanning tech.
14. Analyzes, researches, and processes insurance claims timely.
15. Processes claim updates as directed by facility or coding liaisons.
16. Evaluates electronic insurance rejections for retransmission with corrected info.
17. Handles rebill requests appropriately.
18. Audits claims/accounts for charges, duplications, and overlaps before billing, documenting actions taken.
19. Informs Billing Managers of charging or edit trends, providing examples and education to reduce errors.
20. Performs other duties as assigned and complies with all policies and standards.

Qualifications

1. H.S. Diploma or GED required.
2. Associate Degree preferred.
3. Less than 1 year experience in a hospital or medical setting, or coursework in a related area required.
4. 1-3 years billing experience in a medical facility preferred.

Knowledge, Skills, and Abilities

• Proficiency in Word Processing, Spreadsheet, and Email software.

Equal Employment Opportunity

Community Health Systems does not discriminate based on race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military service, in accordance with applicable laws. Reasonable accommodations are available for applicants with disabilities. For assistance, contact Human Resources at the facility or visit http://www.chs.net/serving-communities/locations/.

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Accounting/Auditing and Finance
• Industries: IT Services and IT Consulting

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