Revenue Cycle Specialist - Self Pay

Community Health Systems, Inc.; United States; On-site; USD 42,000 - 68,000; Full time

Benefits offered by this job

401(k) with matching

Student loan repayment assistance

Tuition assistance

Comprehensive health coverage

Job summary

Community Health Systems, Inc. is seeking a Revenue Cycle Specialist - Self Pay to join our Nashville Shared Services Center.

You will perform follow-up on outstanding insurance balances, identify claim issues, and ensure timely resolutions in line with government and managed care terms. You will communicate with payers, document activity, and support revenue cycle operations while complying with HIPAA and other regulations.

Qualifications

• Explicit requirements include a high school diploma or GED, and an associate degree is preferred.
• Experience in medical collections or healthcare revenue cycle operations is required or preferred.
• Strong understanding of medical collections processes and payer denial resolution is expected.

Responsibilities

• Follow up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or documentation.
• Document all actions taken on accounts in the system to ensure a traceable resolution process.
• Make outbound calls to insurance payers while maintaining professional communication.
• Handle and resolve incoming correspondence within five days of receipt, updating the system accordingly.
• Analyze assigned accounts using AS400, Meditech, Cerner, directory assistance, and credit reports to maximize collections.
• Process inbound and outbound calls professionally, providing excellent customer service while resolving balances.
• Ensure proper application of account dispositions and adherence to self-pay policies and procedures.
• Comply with HIPAA, FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and other healthcare finance regulations.
• Perform other duties as assigned, maintain regular attendance, and follow policies.

Skills

Medical collections

Payer communication

Accounts receivable

EMR systems

Regulatory compliance

Education

High School Diploma or GED

Associate Degree in Business/Finance/Healthcare Administration

Tools

AS400

Meditech

Cerner

Credit reports

Job description

Benefits

• 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.

Job Summary

The Revenue Cycle Specialist - Self Pay is responsible for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations.

Essential Functions

• Performs follow-up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or required documentation.
• Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process.
• Makes the required number of outbound calls to insurance payers while maintaining professional and courteous communication.
• Handles and resolves incoming correspondence within five days of receipt, updating the system with relevant information.
• Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts.
• Processes inbound and outbound calls professionally, providing exceptional customer service while resolving outstanding balances.
• Ensures proper application of account dispositions and follows self-pay policies and procedures.
• Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards.
• 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, Finance, Healthcare Administration, or a related field preferred
• 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required
• Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred

Knowledge, Skills and Abilities

• Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution.
• Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software.
• Knowledge of insurance contracts, denials management, and accounts receivable workflows.
• Excellent problem-solving and analytical skills to research and resolve outstanding claims.
• Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams.
• Strong attention to detail with the ability to document account activity accurately.
• Ability to work independently in a fast-paced environment while meeting productivity and quality standards.
• Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws.

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.