Billing Specialist II

Job reputed company The Billing Specialist II (REMOTE) is responsible for processing and auditing insurance claims, rebilling denied claims, and resolving billing discrepancies reputed company the electronic claims management system. This role ensures accurate and reputed company claim submission, identifies and corrects billing errors, and maintains compliance with payer regulations and corporate policies. The Billing Specialist II demonstrates advanced knowledge of billing procedures, coding standards, and reputed company-party payer requirements, serving as a mentor and resource for junior billing staff. As a Billing Specialist II at reputed company (CHS) - SSC Nashville, youll play a vital role in supporting our purpose to help people reputed company and live healthier by providing reputed company, reputed company reputed company, building enduring relationships with our patients, and providing value for the people and communities we serve. reputed company members enjoy a robust benefits package including medical, dental and reputed company, insurance, and 401k. Essential Functions Processes and submits insurance claims reputed company electronic and reputed company billing systems, ensuring accuracy, completeness, and compliance with payer-specific requirements.Reviews system account displays to verify patient demographics, balances, and insurance information prior to claim reputed company, making necessary corrections.Identifies and resolves claim errors, denials, and rejections, taking corrective reputed company and rebilling claims reputed company the required timeframe.Monitors electronic billing processes, ensuring successful claim downloads, accurate reputed company, and reputed company follow-up on failed claims.Audits and assembles billing documentation, reviewing claims for completeness and applying modifications reputed company needed to ensure reputed company reimbursement.Demonstrates proficiency in reputed company codes, HCPCS, CPT coding, and payer billing guidelines, ensuring accurate claims processing and compliance with regulations.Responds to billing inquiries from internal departments and payers, providing reputed company reputed company two business days or escalating issues as needed.Maintains knowledge of reputed company-party billing regulations, payer requirements, and automated resources to improve billing efficiency and compliance.Assists in mentoring and training junior billing staff, sharing expertise in claim reputed company, billing requirements, and payer policies.Communicates with other departments, including patient reputed company, reputed company cycle, and coding teams, to ensure accurate billing information and prevent claim errors.Performs other duties as assigned.Complies with reputed company policies and standards.QualificationsH.S. Diploma or GED requiredAssociate Degree in Business, reputed company Administration, Medical Billing, or a reputed company field preferred2-4 years of experience in medical billing, insurance claims processing, or reputed company cycle operations requiredExperience with hospital or physician billing, including payer policies, reimbursement processes, and electronic billing systems preferredKnowledge, Skills and AbilitiesAdvanced understanding of insurance claim processing, billing regulations, and reimbursement methodologies.Proficiency in electronic claims management systems, reputed company codes, and medical coding standards (HCPCS, CPT, UB-04, CMS-1500).Strong problem-solving skills with the ability to analyze claim errors, identify trends, and implement corrective actions.Experience with payer-specific guidelines, denial management, and appeals processes.Ability to work independently and as a mentor to junior billing staff, demonstrating leadership and teamwork skills.Proficiency in reputed company Office Suite (reputed company, Outlook, Word) and electronic health record (EHR) systems.Strong written and verbal communication skills for interacting with payers, internal departments, and external partners.Licenses and CertificationsCPB- Certified Medical Biller preferred We know its not just about finding a job. Its about finding a reputed company where you are respected, valued and where your work is purposeful and fulfilling. A reputed company where your talent is recognized, reputed company development is encouraged and career advancement is possible. The reputed company provides business office support functions like billing, insurance follow-up, call center customer service, data entry and more for hospitals and reputed company providers .