[Hiring] Medical Collections Specialist @Community Health Systems Professional Services Corporation

Role Description

As a Remote Medical Collections Specialist - Medicaid 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.

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

This is a fully remote opportunity.

Qualifications

• 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
• 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

• Paid Time Off (PTO)
• Comprehensive Health Benefits - Medical, Dental & Vision
• 401k with company match
• Tuition reimbursement

Company Description

Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.

This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.