As a Remote Billing Specialist at Community Health Systems (CHS) - Shared Services Center, you’ll play a vital role in quality healthcare, building enduring relationships with patients, and providing value for the communities served.

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

Essential Functions:

Process and submit primary and secondary insurance claims accurately and timely, ensuring compliance with payer guidelines and regulatory requirements.
Review and resolve claim errors, rejections, and denials; correct and resubmit claims as needed.
Demonstrate working knowledge of billing forms including UB-04, CMS-1500, or state-specific forms.
Audit claims for accuracy, checking for duplicates, overlaps, and missing information.
Investigate and process rebill requests, verifying claim accuracy and updating as directed.
Maintain knowledge of billing regulations, payer policies, and electronic submission guidelines.
Use electronic billing systems to analyze, research, and transmit claims with proper documentation.
Monitor and report charging or edit trends; collaborate to improve billing accuracy.
Perform daily balancing tasks using SSI and other billing systems; escalate unresolved issues.
Communicate professionally with payers, facility representatives, and internal teams.
Comply with all policies and standards; perform other duties as assigned.

Qualifications:

High School Diploma or GED required.
Associate Degree in Business, Healthcare Administration, Medical Billing or related field preferred.
0-1 years of experience in medical billing, insurance claims processing, or revenue cycle operations required.
Preferred 1-3 years experience in medical facility, ambulatory surgery, or acute care billing.
Experience with hospital or physician billing and payer policies preferred.

Knowledge, Skills, and Abilities:

Basic understanding of insurance claim processing, medical billing, reimbursement guidelines.
Familiarity with billing software, electronic claims management systems (e.g., SSI, Pulse/DAR), eligibility tools.
Knowledge of CMS, Medicaid, Medicare, and commercial insurance billing regulations.
Ability to analyze and resolve claim errors, denials, and rejections.
Strong attention to detail, organizational skills, and ability to meet deadlines.
Proficiency in Microsoft Office and electronic health record (EHR) systems.
Excellent communication and problem-solving skills.

Community Health Systems is one of the nation's leading healthcare providers serving multiple states.