Remote Medical Collections Specialist

About the role

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.

Responsibilities

• 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.
• Maintains strict confidentiality of patient and financial information, ensuring compliance with HIPAA and corporate policies.
• Collaborates with revenue cycle teams and payers to investigate claim denials and appeal decisions when necessary.
• Monitors and follows up on outstanding claims, ensuring timely resolution and payment collection.
• Identifies process improvement opportunities, contributing to increased efficiency and streamlined reimbursement workflows.
• Documents account actions accurately and thoroughly in the appropriate systems, maintaining compliance with department protocols.

Requirements

• 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.

Qualifications

• 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.

Skills

• 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.

Benefits

• Comprehensive Health Benefits - Medical, Dental & Vision
• 401k with company match

Pay

Commensurate with experience.

Schedule

Full-time, remote.