Billing Specialist - Pediatrics - Oak Grove

Community Health Systems•Hattiesburg, MS

18h

About The Position

The Billing Specialist I is responsible for insurance claim processing, billing, and follow-up to ensure timely and accurate reimbursement. The position serves as a primary contact for insurance companies and other payers, researching and resolving claim issues while complying with billing regulations and organizational policies. The role also assists patients and insurance representatives with billing inquiries and collaborates with management, clinic staff, and coding teams to support proper billing and collection procedures.

Requirements

0–2 years of experience in medical billing, insurance claims processing, or revenue cycle management.
Knowledge of medical billing processes, insurance claim procedures, and payer policies.
Strong understanding of healthcare revenue cycle operations and reimbursement methodologies.
Proficiency with electronic health records (EHR) and practice management systems.
Ability to interpret explanations of benefits (EOBs), identify billing discrepancies, and take corrective action.
Excellent communication and interpersonal skills when interacting with patients, providers, and payers.
Strong analytical and problem-solving abilities to research and resolve billing issues.
Attention to detail and ability to manage multiple tasks while meeting deadlines.
Working knowledge of HIPAA regulations and patient confidentiality.
Authorization to work in the U.S. for an employer; immigration sponsorship is not available now or in the future.

Nice To Haves

Certified Professional Biller (CPB), issued by AAPC.
Certified Medical Insurance Specialist (CMIS), issued by PMI.
Experience with Athena, Cerner, or Ingenious Med.

Responsibilities

Submit and process claims accurately and efficiently in accordance with payer requirements and company policies.
Communicate with insurance companies, patients, and other stakeholders to resolve billing inquiries and maintain account status.
Review and reconcile credit balances, reclassify revenue, and process adjustments according to transaction coding guidelines.
Monitor and resolve claim denials and rejections, identify trends, and implement corrective actions.
Review and correct claim filing edits based on payer requirements and electronic health record (EHR) system alerts.
Maintain accurate documentation of billing actions in the practice management system.
Gather, update, and communicate billing policy changes and keep reference materials current and accessible.
Collaborate with management, clinic staff, and coding teams to ensure proper billing and collection procedures.
Assist patients and insurance representatives with billing-related questions professionally.
Comply with HIPAA regulations and maintain confidentiality of patient financial and medical information.
Maintain regular and reliable attendance and comply with organizational policies and standards.
Perform other duties as assigned.