Revenue-Cycle Billing Specialist

Holy Cross Medical Center; Taos (NM); On-site; USD 42,000 - 64,000; Full time

Job summary

Holy Cross Medical Center is seeking a dedicated Claims Billing Specialist to ensure accurate and timely submission of insurance claims and robust follow-up. You will work with the Patient Financial Services Director and billing staff to maximize reimbursement while adhering to all federal and state requirements.

A strong background in denial management, appeals, and CAH reimbursement methodologies will help drive efficient revenue cycle operations.

Qualifications

• Knowledge of the back-end revenue cycle, including government and commercial insurance processes.
• Thorough understanding of medical billing and insurance collections.
• Ability to research and resolve complex outstanding claims through critical thinking and problem-solving.
• Experience with denial management, appeals, claim corrections, and reimbursement recovery.
• Excellent computer skills with proficiency in EHR systems, billing software, clearinghouses, Microsoft Office, and payer portals.
• Ability to communicate effectively with insurance representatives to resolve claim issues and negotiate reimbursement.
• Excellent verbal and written communication skills.
• Strong organizational, analytical, and time management skills.
• High attention to detail and ability to prioritize multiple tasks.

Responsibilities

• Handle accurate and timely submission of insurance claims and follow-up.
• Manage denial resolution, appeals, and reimbursement efforts.
• Collaborate with Patient Financial Services leadership, billing staff, and payers to ensure clean claims.
• Research complex claims and coordinate corrective actions with payers and internal teams.
• Maintain confidentiality and comply with regulatory guidelines.

Skills

Denial management

Appeals

Insurance follow-up

Billing accuracy

EHR proficiency

Billing software

Clearinghouses

Payer portals

Microsoft Office

Education

High school diploma or GED

Associate degree in Healthcare Administration/Business

Certified Professional Biller (CPB)

CAH reimbursement experience

Tools

EHR systems

Billing software

Clearinghouses

Payer portals

Microsoft Office

Job description

Holy Cross Medical Center is seeking a dedicated Claims Billing Specialist to ensure accurate and timely submission of insurance claims and robust follow-up. You will work with the Patient Financial Services Director and billing staff to maximize reimbursement while adhering to all federal and state requirements.

A strong background in denial management, appeals, and CAH reimbursement methodologies will help drive efficient revenue cycle operations.