Remote Medical Collections Specialist - Medicare

Community Health Systems Professional Services Corporation•Fort Smith, AR

19h•Remote

About The Position

The Remote Medical Collections Specialist at Community Health Systems (CHS) Shared Services Center processes, reviews, and verifies reimbursement claims to ensure accuracy, compliance, and timely resolution. The role analyzes account balances, identifies discrepancies, and applies transaction codes to support accurate claims processing. It collaborates with internal teams to promote workflow efficiency, revenue integrity, and compliance with payer guidelines while meeting productivity and accuracy standards. This is a fully remote opportunity. The 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.

Requirements

High school diploma or GED.
0–1 years of experience in medical billing, reimbursement, claims processing, or accounts receivable.
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.
Effective communication and collaboration skills with payers, revenue cycle teams, and internal departments.
Knowledge of HIPAA, compliance regulations, and healthcare reimbursement standards.
Authorization to work in the U.S. for any employer; immigration sponsorship is not available.

Nice To Haves

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

Responsibilities

Process and verify reimbursement claims for accuracy and compliance with payer guidelines and regulatory requirements.
Review and resolve claim discrepancies, including incorrect payments, denials, and underpayments.
Apply correct transaction codes to accounts to support proper claim adjudication and reimbursement flow.
Monitor and follow up on outstanding claims to ensure timely resolution and payment collection.
Collaborate with revenue cycle teams and payers to investigate claim denials and appeal decisions when necessary.
Research and interpret payer policies and adhere to reimbursement requirements and claim submission rules.
Accurately document account actions in appropriate systems in compliance with department protocols.
Identify process improvement opportunities to increase efficiency and streamline reimbursement workflows.
Maintain confidentiality of patient and financial information in compliance with HIPAA and corporate policies.
Perform other duties as assigned.
Comply with all policies and standards.