Claims Billing & Reimbursement Specialist

Holy-Cross-Medical-Center; Taos (NM); On-site; USD 42,000 - 62,000; Full time

Job summary

Holy-Cross-Medical-Center is seeking a Claims Billing Specialist to ensure accurate and timely submission of insurance claims, follow-up, and appeals to maximize reimbursement. The role collaborates with the Patient Financial Services Director and Billing staff to maintain compliance with federal, state, payer, and organizational guidelines.

Ideal candidates will have experience with CPT/HCPCS/ICD-10-CM coding, strong communication, and proficient use of EHR systems and billing software.

Qualifications

• Minimum high school diploma or GED; an associate degree is preferred.
• CPB certification is preferred.
• Experience with Critical Access Hospital (CAH) reimbursement methodologies.
• Strong research and problem-solving for complex claims.

Responsibilities

• Submit and follow up on insurance claims to maximize reimbursement.
• Manage denials, appeals, and corrections.
• Collaborate with Patient Accounts team to ensure accuracy and compliance.

Skills

Insurance billing

Denial management

Appeals

CPT/HCPCS/ICD-10-CM

Medical terminology

EHR software

Microsoft Office

Communication

Organization

Education

Associate degree in Healthcare Administration

CPB certification

CAH reimbursement knowledge

High school diploma

Tools

Billing software

Job description

Holy-Cross-Medical-Center is seeking a Claims Billing Specialist to ensure accurate and timely submission of insurance claims, follow-up, and appeals to maximize reimbursement. The role collaborates with the Patient Financial Services Director and Billing staff to maintain compliance with federal, state, payer, and organizational guidelines.

Ideal candidates will have experience with CPT/HCPCS/ICD-10-CM coding, strong communication, and proficient use of EHR systems and billing software.