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 Billing Specialist II is responsible for processing and auditing insurance
claims, rebilling denied claims, and resolving billing discrepancies within the
electronic claims management system. This role ensures accurate and timely 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
third-party payer requirements, serving as a mentor and resource for junior
billing staff.
Essential Functions
Processes and submits insurance claims via electronic and paper 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 generation, making necessary
corrections.
Identifies and resolves claim errors, denials, and rejections, taking
corrective action and rebilling claims within the required timeframe.
Monitors electronic billing processes, ensuring successful claim downloads,
accurate transmission, and timely follow-up on failed claims.
Audits and assembles billing documentation, reviewing claims for completeness
and applying modifications when needed to ensure proper reimbursement.
Demonstrates proficiency in revenue 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
resolution within two business days or escalating issues as needed.
Maintains knowledge of third-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 resolution, billing requirements, and payer policies.
Communicates with other departments, including patient access, revenue cycle,
and coding teams, to ensure accurate billing information and prevent claim
errors.
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, Healthcare Administration, Medical Billing, or
a related field preferred
2-4 years of experience in medical billing, insurance claims processing, or
revenue cycle operations required
Experience with hospital or physician billing, including payer policies,
reimbursement processes, and electronic billing systems preferred
Knowledge, Skills and Abilities
Advanced understanding of insurance claim processing, billing regulations,
and reimbursement methodologies.
Proficiency in electronic claims management systems, revenue 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 Microsoft Office Suite (Excel, 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 Certifications
CPB- Certified Medical Biller preferred
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.
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.