(Remote) Hospital Billing Representative
$37,440–$58,240 year
RemoteUnited States
United StatesRemoteFull Time$37,440–$58,240 yearEnterprise
Full TimeEnterprise
Job Summary
Review, correct, and submit initial hospital claims through billing clearinghouses and payer systems, ensuring accurate diagnosis, procedure, and charge codes meet payer guidelines before release. Resolve front-end claim edits, rejected files, and rebills while maintaining a high clean claim rate. Communicate with hospitals, internal teams, and payers to address authorization details, demographics, or formatting issues. Submit billing requests and worked time by departmental deadlines while adhering to HIPAA privacy standards. This remote role requires CST timezone preference and experience with clearinghouses like Availity or Change Healthcare.
Required Qualifications
- High School diploma or equivalent
- Minimum 1 year of front end hospital billing experience
- Minimum 1 year of experience submitting hospital claims through billing clearinghouses
- Minimum 1 year of experience utilizing hospital claims management or billing software
- Experience resolving front end claim edits before payer adjudication
- Working knowledge of institutional hospital claims, payer billing requirements, clean claim submission, rebills, corrected claims, late charges, DDE claims, and claim edit resolution
- Ability to clearly explain prior experience with clearinghouses such as SSI, Availity, Waystar, Change Healthcare, TrueBridge, or Quadax
- Ability to identify claim errors before submission and take appropriate corrective action
- Ability to follow billing standards, department procedures, and payer guidelines independently
- Strong attention to detail and ability to manage billing inventory accurately
- Computer skills in Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook
- Customer service orientation with the ability to support internal teams, facilities, and customers professionally
- High speed internet access with minimum 300 Mbps download speed and unlimited data
- Smart phone for Multi Factor Authentication application
- Ability to access protected health information in accordance with departmental assignments and guidelines
- Skilled in making accurate arithmetic computations
- Excellent verbal and written communication skills
- Good judgment, tact, initiative, and resourcefulness
- Detail oriented, organized, and able to manage multiple priorities
- Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives
- Flexible with a can do attitude and ability to remain professional under high pressure situations
- High speed internet access with minimum 300 Mbps download speed and unlimited data
- Smart phone for Multi Factor Authentication application
- Ability to access protected health information in accordance with departmental assignments and guidelines
- Skilled in making accurate arithmetic computations
- Excellent verbal and written communication skills
- Good judgment, tact, initiative, and resourcefulness
- Detail oriented, organized, and able to manage multiple priorities
- Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives
- Flexible with a can do attitude and ability to remain professional under high pressure situations
Desired Qualifications
- MEDHOST or HMS knowledge
- Experience maintaining a strong clean claim rate
- Experience submitting Medicare, Medicaid, Blue Cross, commercial, and government payer claims
- Experience working claim edit queues within a hospital billing environment
- Experience with UB04, 837I, DDE, rebills, corrected claims, late charges, and clearinghouse edits
- Knowledge of hospital billing, revenue cycle, and medical terminology
- Ability to navigate healthcare information systems and clearinghouses
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