Senior Medical Billing & Claims Specialist

CHS Career Site; Birmingham (AL); On-site; USD 42,000 - 56,000; Full time

Job summary

CHS Career Site seeks a Billing Specialist II to manage complex billing processes and maximize collections. You will be the primary liaison for insurance payers, performing in-depth research to resolve issues and ensure accurate claims processing.

You will train staff, support audits, and ensure compliance with payer regulations and company policies while maintaining confidentiality and HIPAA standards.

Qualifications

• 2–4 years in medical billing, insurance claims processing, or revenue cycle management.
• 1–3 years in collections and insurance reimbursement.
• 0–1 years of Medicare experience preferred.

Responsibilities

• Serve as the primary contact for insurance companies, payers, and patients on billing inquiries and claim resolution.
• Review and process insurance claims, ensuring timely submission and payer guideline compliance.
• Identify and resolve credit balances, reclassify revenue, and process adjustments per coding policies.
• Review claim edits in EHR/PM systems (Athena, Cerner, Ingenious Med).
• Research and resolve claim denials and rejections; identify trends and apply corrective actions.
• Monitor vendor/payer audit trails and address discrepancies; submit secondary claims as needed.
• Maintain up-to-date knowledge of payer guidelines and HIPAA requirements.
• Assist in staff training on billing updates and maintain reference materials.

Skills

Healthcare billing

Payer communications

Revenue cycle management

Denials resolution

HIPAA compliance

Audit support

Staff training

Education

CPB - Certified Medical Biller

CMIS - Certified Medical Insurance Specialist

Tools

Athena

Cerner

Ingenious Med

Job description

CHS Career Site seeks a Billing Specialist II to manage complex billing processes and maximize collections. You will be the primary liaison for insurance payers, performing in-depth research to resolve issues and ensure accurate claims processing.

You will train staff, support audits, and ensure compliance with payer regulations and company policies while maintaining confidentiality and HIPAA standards.