Billing Specialist I

@ Community Health Systems

Job Summary

The Billing Specialist I is responsible for processing, auditing, and submitting primary and secondary insurance claims, ensuring accuracy, compliance, and timely reimbursement. This role utilizes electronic claims management systems to review, correct, and resolve billing errors, denials, and rejections. It involves collaboration with internal teams, facility liaisons, and payers to ensure clean claim submission and adherence to federal, state, and payer-specific regulations.

Role Overview at Community Health Systems

As a Billing Specialist at Community Health Systems (CHS) - Physician Practice Support Inc. (PPSI), you play a vital role in supporting the mission to help people get well and live healthier. The role is central to providing safe, quality healthcare, building enduring relationships with patients, and adding value to communities.

Essential Functions

• Process and submit insurance claims accurately and timely.
• Review and resolve claim errors, rejections, and denials.
• Audit claims for accuracy and compliance with billing regulations.
• Investigate rebill requests and coordinate with facility or coding liaisons.
• Utilize electronic billing systems and document actions in the collection system.
• Collaborate with teams such as coding, patient access, and ancillary departments.
• Perform daily balancing tasks and escalate issues as needed.
• Communicate professionally with payers and internal teams.
• Comply with all policies and standards.

Qualifications

• H.S. Diploma or GED required; Associate Degree preferred.
• 0-1 years of experience in medical billing or claims processing required.
• 1-3 years of billing experience in a medical facility preferred.
• Experience with hospital or physician billing and electronic claims systems is a plus.

Knowledge, Skills And Abilities

• Understanding of insurance claim processing, medical billing and reimbursement guidelines.
• Familiarity with billing software and electronic claims management systems.
• Knowledge of CMS, Medicaid, Medicare, and commercial insurance regulations.
• Strong attention to detail and organizational skills.
• Proficiency in Microsoft Office Suite and electronic health record systems.
• Excellent communication and problem-solving abilities.

Licenses and Certifications

CPB - Certified Medical Biller is preferred.

Additional Information

Community Health Systems is among the nation’s leading healthcare providers, operating in 40 markets across 15 states with acute-care hospitals and over 1,000 sites of care. The role supports the PPSI Team in creating a clean and efficient revenue cycle.

Key Skills/Competency

• Billing
• Claims Processing
• Auditing
• Compliance
• Insurance
• Electronic Systems
• Reimbursement
• Healthcare
• Detail-Oriented
• Communication