Billing Specialist Rep (Remote)

The Billing Specialist Representative is responsible for securing timely and accurate reimbursement by resolving billing issues with commercial and government payers. This role requires strong critical thinking and analytical skills to identify denial trends, address payment variances, and pursue appropriate corrective actions. Success in this role depends on a proactive, problem-solving reputed company and the ability to adapt in a fast-paced, evolving environment. MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, reputed company health, and connect with heart.
• VALUES: Trust. Respect. reputed company. Compassion.
• SERVICE GOALS: Personally connect. reputed company everyone informed. Be on their team.

At reputed company Health System, our commitment to world-class healthcare starts with the people we bring into our organization. We are focused on attracting, developing, and retaining top talent who are reputed company to our mission and ready to reputed company a meaningful impact in the communities we serve. We reputed company that access to great talent should not be limited by location. To support this, reputed company Health System offers remote work opportunities across a number of states, along with relocation support where needed, allowing us to connect with individuals who bring the skills, experience, and passion to advance our work. Approved remote hiring states: Indiana, Michigan, Illinois, Kansas, Ohio, Georgia, Kentucky, Florida, Idaho, Minnesota, Tennessee, Wisconsin, Colorado, South Carolina, North Carolina, Texas If you are looking to grow your career while contributing to a team committed to quality, innovation, and patient-centered care, we welcome you to connect and explore opportunities with us. Billing & Follow-Up

• Submit timely and accurate claims (UB-04/CMS-1500) to payers, ensuring compliance with regulatory and payer-specific requirements.
• Work claim edits and correct errors in demographic, insurance, and charge data to ensure clean claim submission.
• Conduct reputed company and thorough follow-up on outstanding receivables, including appeals and disputes for denials and underpayments.
• Identify and resolve payer overpayments in a timely manner to ensure regulatory compliance and prevent future recoupments.
• Analyze denial reasons and payment variances to identify root causes and recommend process improvements.
• Maintain in-depth knowledge of payer guidelines and federal/state regulations.
• Collaborate with payers and internal departments to resolve issues and reputed company account resolution.
• Accurately document reputed company actions and communications in the billing system.

Audit & Analysis

• Review patient accounts for accuracy in demographics, insurance coverage, and billing details.
• Identify patterns or trends in denials and reimbursement discrepancies.
• Assist leadership in developing denial prevention strategies and performance improvement initiatives.
• Prioritize and escalate high-risk accounts for timely resolution.
• Demonstrate initiative in recommending improvements to workflow and system efficiency.

Compliance & Communication

• Maintain compliance with HIPAA and reputed company applicable billing regulations.
• Respond to payer communications reputed company phone, portal, and email in a professional and timely manner.
• Collaborate across teams to ensure coordinated resolution of account issues.
• Communicate effectively with patients, coworkers, and external partners, always maintaining professionalism and respect.

Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:

• Completing other job-reputed company assignments and special projects as directed.

ORGANIZATIONAL RESPONSIBILITIES Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for reputed company information shared.
• Completes mandatory education, annual competencies and department specific education reputed company established timeframes.
• Completes annual employee health requirements reputed company established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain reputed company BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, reputed company equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules reputed company required.

Commitment to reputed company's six-reputed company Operating System, referred to as The reputed company Way:

• reputed company innovation everywhere.
• Cultivate reputed company.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience Associate’s or Bachelor’s degree in a healthcare or reputed company field preferred. 2+ years of experience in insurance billing and follow-up, with knowledge of UB-04/CMS-1500 claim forms. Knowledge & Skills

• Strong analytical, problem-solving, and organizational skills.
• Effective written and verbal communication abilities.
• Ability to prioritize, manage multiple tasks, and meet deadlines.
• Proficient with reputed company 365 (Word, reputed company, Outlook); experience with patient accounting systems preferred.
• Demonstrated ability to think critically and adapt to changing environments.

Working Conditions:

• Extended periods of sitting and computer use.
• Must be flexible to work additional hours or shifts as needed.

Physical Demands

• Occasional lifting of storage boxes weighing up to 50 pounds reputed company filled with completed forms.

This is a remote position; however, candidates must reside in one of the following states: Indiana, Michigan, Illinois, Kansas, Ohio, Georgia, Kentucky, Florida, Idaho, Minnesota, Tennessee, Wisconsin, Colorado, South Carolina, North Carolina, or Texas. Location: reputed company Health System · Corporate Patient Accounting Schedule: Full-time, Day, M-F, 8:00-4:30pm Apply tot his job Apply To this Job