Billing Specialist II - Host Unbilled (REMOTE)

Community Health Systems

United States

Remote

USD 42,000 - 57,000

Full time

3 days ago

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Benefits offered by this job

Health coverage

401(k) with match

Student loan assistance

Tuition assistance

Competitive pay

Paid time off

Job summary

Community Health Systems seeks a Billing Specialist II - Host Unbilled for processing and auditing insurance claims, rebilling denied claims, and resolving billing discrepancies in a compliant and timely manner.

Proficiency in HCPCS, CPT coding, payer guidelines, and electronic billing systems is required. This remote role supports teams across the United States within our Shared Services Center in Nashville.

Qualifications

H.S. Diploma or GED required.
Associate degree preferred.
2–4 years of medical billing or revenue cycle experience required.
Experience with hospital/physician billing and electronic billing systems preferred.

Responsibilities

Process and submit insurance claims via electronic and paper billing systems with accuracy and compliance.
Review system displays to verify demographics and insurance information before claim generation.
Identify and resolve claim errors, denials, and rejections; rebill within required timeframes.
Monitor electronic billing processes and follow up on failed claims.
Audit and assemble billing documentation; apply modifications for proper reimbursement.
Demonstrate proficiency in HCPCS, CPT, and payer guidelines for accurate claims.
Respond to billing inquiries from internal teams and payers within two business days.
Stay informed on third-party regulations and payer requirements; mentor junior staff.

Skills

Insurance claim processing

Billing regulations

EHR systems

Microsoft Office Suite

Education

H.S. Diploma or GED

Associate Degree in Business, Healthcare Administration, Medical Billing, or related field

Tools

Electronic billing systems

Revenue codes & CPT/HCPCS knowledge tools

Job description

Billing Specialist II - Host Unbilled (REMOTE)

United States

Trending

Job Description

Comprehensive Health Coverage - Medical, dental, and vision plans to keep you and your family healthy.
Future Security: 401(k) with matching
Student Loan Support - Up to $10,000 repayment assistance, because we invest in your future.
Educational Tuition Assistance
Competitive Pay & Full Benefits - A salary and package designed to reward your expertise and dedication.
Paid Time Off

Job Summary

The Billing Specialist II - Host Unbilled is responsible for processing and auditing insurance claims, rebilling denied claims, and resolving billing discrepancies within the electronic claims management system. This role ensures accurate and timely claim submission, identifies and corrects billing errors, and maintains compliance with payer regulations and corporate policies. The Billing Specialist II demonstrates advanced knowledge of billing procedures, coding standards, and third-party payer requirements, serving as a mentor and resource for junior billing staff.

Essential Functions

Processes and submits insurance claims via electronic and paper billing systems, ensuring accuracy, completeness, and compliance with payer-specific requirements.
Reviews system account displays to verify patient demographics, balances, and insurance information prior to claim generation, making necessary corrections.
Identifies and resolves claim errors, denials, and rejections, taking corrective action and rebilling claims within the required timeframe.
Monitors electronic billing processes, ensuring successful claim downloads, accurate transmission, and timely follow-up on failed claims.
Audits and assembles billing documentation, reviewing claims for completeness and applying modifications when needed to ensure proper reimbursement.
Demonstrates proficiency in revenue codes, HCPCS, CPT coding, and payer billing guidelines, ensuring accurate claims processing and compliance with regulations.
Responds to billing inquiries from internal departments and payers, providing resolution within two business days or escalating issues as needed.
Maintains knowledge of third-party billing regulations, payer requirements, and automated resources to improve billing efficiency and compliance.
Assists in mentoring and training junior billing staff, sharing expertise in claim resolution, billing requirements, and payer policies.
Communicates with other departments, including patient access, revenue cycle, and coding teams, to ensure accurate billing information and prevent claim errors.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.

Qualifications

H.S. Diploma or GED required
Associate Degree in Business, Healthcare Administration, Medical Billing, or a related field preferred
2-4 years of experience in medical billing, insurance claims processing, or revenue cycle operations required
Experience with hospital or physician billing, including payer policies, reimbursement processes, and electronic billing systems preferred

Knowledge, Skills and Abilities

Advanced understanding of insurance claim processing, billing regulations, and reimbursement methodologies.
Proficiency in electronic claims management systems, revenue codes, and medical coding standards (HCPCS, CPT, UB-04, CMS-1500).
Strong problem-solving skills with the ability to analyze claim errors, identify trends, and implement corrective actions.
Experience with payer-specific guidelines, denial management, and appeals processes.
Ability to work independently and as a mentor to junior billing staff, demonstrating leadership and teamwork skills.
Proficiency in Microsoft Office Suite (Excel, Outlook, Word) and electronic health record (EHR) systems.
Strong written and verbal communication skills for interacting with payers, internal departments, and external partners.

Licenses and Certifications

CPB- Certified Medical Biller preferred

We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.

The Shared Services Center - Nashville provides business office support functions like billing, insurance follow-up, call center customer service, data entry and more for hospitals and healthcare providers. But we're not only about work. We know employing a skilled and engaged team of professionals is vitally important to our success, so we make sure to offer competitive benefits, recognition programs, professional development opportunities and a fun and engaging team environment.

Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.

Job Info