Hybrid Medical Billing: Claims Specialist - Greenville, SC

Day in the Life of a Claims Specialist

• Accurately enter patient charges, diagnoses (ICD-10), procedures (CPT/HCPCS), modifiers, and units into billing systems.
• Review charge documents for completeness, accuracy, and compliance prior to entry.
• Identify and correct errors, discrepancies, and duplicate charges before claim submission.
• Ensure charges align with provider documentation and payer requirements.
• Maintain productivity and quality standards while meeting daily deadlines, especially during end-of-month (EOM).
• Communicate effectively with internal teams (coding, billing, AR, leadership) to resolve charge-related issues.
• Follow HIPAA guidelines and protect patient confidentiality at all times.
• Adhere to departmental workflows, policies, and compliance standards.
• Participate in audits, quality reviews, and ongoing training as assigned.

Education And Experience Requirements

• A high school diploma or equivalent.
• A high attention to detail and accuracy.
• A strong knowledge of medical terminology, CPT, ICD-10, and basic billing rules.
• The ability to work efficiently in high-volume environments.
• Proficiency in billing systems and electronic health records (e.g., Medgen, CareLogic, or similar).
• Strong time management, organization, and communication skills.
• The ability to work independently and collaboratively as part of a team.
• Previous experience in healthcare charge entry, billing, or revenue cycle.
• An understanding of payer guidelines and claim submission processes.
• The ability to meet productivity and quality metrics.
• A working knowledge with allowable/contractual amounts, payment terminology, adjustments, identifying patient responsibility.

Position Benefits

• A daily impact on many lives.
• Excellent training if you are new to this field.
• Mileage reimbursement (if applicable).
• Crossroads matches the current IRS mileage reimbursement rate.
• Opportunity to save lives every day!
• A benefits package that includes:
• Medical, Dental, and Vision Insurance
• PPO
• Variety of 401K options including a match program with no vesture period
• Annual Continuing Education Allowance (in related field)
• Life Insurance
• Short/Long Term Disability
• Paid maternity/paternity leave
• Mental Health day
• Calm subscription for all employees