The specialist is responsible for processing, reviewing, and verifying reimbursement claims to ensure accuracy, compliance, and timely resolution. They also analyze account balances, identify discrepancies, and collaborate with internal teams to support revenue integrity.
Requirements overview
Candidates must have a high school diploma or GED and 0-1 years of experience in medical billing or claims processing. An associate degree in a related field is preferred, along with knowledge of payer policies and healthcare revenue cycle operations.
Key skills
Medical billingReimbursement proceduresPayer guidelinesClaim submissionDenial managementAppeals processesAccount analysisElectronic health recordsBilling softwareProblem-solvingCritical-thinkingCommunicationCollaborationHIPAA complianceRevenue cycle operations
Resume keywordsJigup Pro
This job lists resume keywords
The terms this posting uses, pulled out so you can mirror them in your resume. Jigup Pro members see the list on the job board.
About Community Health Systems Professional Services Corporation
Industry
Hospitals and Health Care
Employees
25,336
Type
Public Company
Size
10,001+ employees
Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 32 distinct markets across 12 states, CHS operates 59 affiliated hospitals with more than 8,000 beds and more than 800 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.
As a Remote Medical Collections Specialist at Community Health Systems (CHS) -
Shared Services Center, you’ll play a vital role in quality healthcare, building
enduring relationships with our patients, and providing value for the people and
communities we serve.
Our team members enjoy a robust benefits package including:
* Paid Time Off (PTO)
* Comprehensive Health Benefits - Medical, Dental & Vision
* 401k with company match
* Tuition reimbursement
The Remote Collections Specialist is responsible for processing, reviewing, and
verifying reimbursement claims to ensure accuracy, compliance, and timely
resolution. This role involves analyzing account balances, identifying
discrepancies, and applying appropriate transaction codes to facilitate accurate
claims processing. The Reimbursement Specialist I collaborates with internal
teams to support workflow efficiency, revenue integrity, and compliance with
payer guidelines while maintaining productivity and accuracy standards.
* Processes and verifies reimbursement claims, ensuring accuracy and compliance
with payer guidelines and regulatory requirements.
* Reviews and resolves claim discrepancies, identifying incorrect payments,
denials, or underpayments and taking appropriate action.
* Applies correct transaction codes to accounts, ensuring proper claim
adjudication and reimbursement flow.
* Monitors and follows up on outstanding claims, ensuring timely resolution and
payment collection.
* Collaborates with revenue cycle teams and payers to investigate claim denials
and appeal decisions when necessary.
* Researches and interprets payer policies, ensuring adherence to reimbursement
requirements and claim submission rules.
* Documents account actions accurately and thoroughly in the appropriate
systems, maintaining compliance with department protocols.
* Identifies process improvement opportunities, contributing to increased
efficiency and streamlined reimbursement workflows.
* Maintains strict confidentiality of patient and financial information,
ensuring compliance with HIPAA and corporate policies.
* Performs other duties as assigned.
* Complies with all policies and standards.
* This is a fully remote opportunity.
Qualifications
* H.S. Diploma or GED required
* Associate Degree or coursework in Accounting, Finance, Healthcare
Administration, or related field preferred
* 0-1 years of experience in medical billing, reimbursement, claims processing,
or accounts receivable required
* Experience with payer reimbursement policies, claim adjudication, and
healthcare revenue cycle operations preferred
Knowledge, Skills and Abilities
* Strong knowledge of medical billing, reimbursement procedures, and payer
guidelines.
* Familiarity with claim submission, denial management, and appeals processes.
* Ability to analyze account balances, identify discrepancies, and apply
appropriate adjustments.
* Proficiency in electronic health records (EHR), billing software, and
reimbursement systems.
* Strong problem-solving and critical-thinking skills, ensuring accurate claims
resolution.
* Effective communication and collaboration skills, working with payers,
revenue cycle teams, and internal departments.
* Knowledge of HIPAA, compliance regulations, and healthcare reimbursement
standards.
We know it’s not just about finding a job. It’s about finding a place where you
are respected, valued and where your work is purposeful and fulfilling. A place
where your talent is recognized, professional development is encouraged and
career advancement is possible.
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.
This position is not eligible for immigration sponsorship now or in the future.
Applicants must be authorized to work in the U.S. for any employer.