Remote Medical Collections Specialist

Community Health Systems Professional Services Corporation•Fort Smith, AR

9h•Remote

About The Position

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. The Remote Collections Specialist is responsible for processing, reviewing, and verifying reimbursement claims to ensure accuracy, compliance, and timely resolution. This role involves analyzing account balances, identifying discrepancies, and applying appropriate transaction codes to facilitate accurate claims processing. The Reimbursement Specialist I collaborates with internal teams to support workflow efficiency, revenue integrity, and compliance with payer guidelines while maintaining productivity and accuracy standards. This is a fully remote opportunity.

Requirements

H.S. Diploma or GED required
0-1 years of experience in medical billing, reimbursement, claims processing, or accounts receivable required
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.
Applicants must be authorized to work in the U.S. for any employer.

Nice To Haves

Associate Degree or coursework in Accounting, Finance, Healthcare Administration, or related field preferred
Experience with payer reimbursement policies, claim adjudication, and healthcare revenue cycle operations preferred

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.
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.