Healthcare Billing & Claims Specialist I

Wellstar Health System, Inc.; Atlanta (GA); On-site; USD 38,000 - 52,000; Full time

Job summary

Wellstar Health System, Inc. is seeking a Billing and Claims Specialist I to manage claim processes, including submission, follow-up, and payer communications. The role involves working in Epic EMR, resolving denials, and ensuring timely revenue capture across Medicare, Medicaid, and commercial payers.

You will participate in process improvements, maintain HIPAA compliance, and collaborate with the Billing team to meet daily productivity and quality goals in a dynamic healthcare setting.

Qualifications

• Minimum 1 year medical billing experience including payer knowledge.
• Experience with Medicare, Medicaid and commercial insurance.
• CPT and ICD-10 coding knowledge applied to claims submission.
• Strong communication and customer service skills under deadlines.

Responsibilities

• Prepares and submits clean claims to third party payers electronically or by paper.
• Analyzes and resolves claim submission edits and payer rejections using medical records.
• Works with clearinghouse (Change Healthcare) for follow-up and issue resolution.
• Coordinates patient eligibility through various third-party sources.
• Maintains confidentiality per HIPAA and organizational policies.
• Meets productivity and quality standards in daily claims processing.
• Identifies opportunities for system and process improvements.

Skills

Medical billing experience

CPT ICD-10 coding

Communication skills

Time management

Problem solving

Education

High School Diploma / GED General

Tools

Epic EMR

Job description

Wellstar Health System, Inc. is seeking a Billing and Claims Specialist I to manage claim processes, including submission, follow-up, and payer communications. The role involves working in Epic EMR, resolving denials, and ensuring timely revenue capture across Medicare, Medicaid, and commercial payers.

You will participate in process improvements, maintain HIPAA compliance, and collaborate with the Billing team to meet daily productivity and quality goals in a dynamic healthcare setting.