Medical Billing Specialist - Remote

American Health Communities; Franklin (TN); Hybrid; USD 42,000 - 56,000; Full time

Job summary

American Health Partners in Franklin, TN, is seeking a Medical Billing Specialist to process and mail or transmit claims, track claims, and monitor payor eligibility. The role also involves posting cash receipts and supporting denials management within the revenue cycle.

Responsibilities include extracting billing information, verifying patient demographics and insurance data, and ensuring timely filing of Medicare and third‑party claims.

Qualifications

• Comply with HIPAA, False Claims Act and corporate policies.
• Maintain professional communication with patients and guarantors.
• Meet productivity goals and complete required training.

Responsibilities

• Extract and verify billing information from medical records
• Ensure all patient demographic and insurance is accurate prior to submitting claims
• Submit and track Medicare, Medicaid, and third‑party insurance claims
• Balance daily charges and reconcile with PMS reports
• Collaborate with revenue cycle manager on denials/rejections
• Assist with patient statements and arrangements for payments when needed
• Maintain and review DAR and PMS entries for accuracy
• Provide accurate patient account information upon request
• Assist with audits and compliance monitoring
• Other duties as assigned

Skills

Problem solving

Communication skills

Interpret instructions

Organizational skills

MS Office

Ten-key accuracy

Education

GED or better

High School or better

Tools

Microsoft Word

Excel

PowerPoint

Internet Explorer

Job description

American Health Partners
Franklin, TN 37067, USA

The Medical Billing Specialist is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process and posting cash receipts.

ESSENTIAL JOB DUTIES:

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.

• Extract and verify billing information from medical records
• Ensuring collection of past due balances; follow up as needed
• Ensure all patient demographic and insurance is accurate prior to submitting claims to insurance companies
• Answer patient account inquiries; assists establish alternative payment plans when necessary
• Maintain patient account records; settle third party payer issues as required
• Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS)
• Prepare and review patient statements prior to release through PMS
• Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims
• Balance daily charges; reconcile with reports within PMS
• Collaborate with revenue cycle manager and payers on denials/rejections
• Work closely with practice representatives to ensure proper insurance verifications and authorizations are obtained
• Other duties as assigned

JOB REQUIREMENTS:

• Comply with applicable legal requirements, standards, policies and procedures including but not limited those within the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims Act
• Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer
• Communicate professionally with patients and guarantors regarding balances or account information
• Participate in required orientation and training programs
• Cooperate with monitoring and audit functions and investigations
• Participate in process improvement responsibilities
• Meet productivity goals
• Successful completion of required training

REQUIRED SKILLS:

• Problem solving skills to manage a variety of concrete variables
• Effective verbal and written communication skills
• Ability to interpret instruction presented in variety of situations
• Strong organizational skills; ability to manage multiple projects simultaneously
• Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
• Ten key speed and accuracy

EQUAL OPPORTUNITY EMPLOYER

This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.

Qualifications

Education

Preferred

GED or better.

High School or better.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.