Hospital Billing Specialist II-1

22.77 - 29.60Care for our community, and your career. Duties and ResponsibilitiesPrepare, review, and submit complex hospital claims, including inpatient, high‑acuity outpatient, surgical, clinic and specialty servicesResolve claim edits requiring in‑depth research across multiple systems (EHR, coding, patient access, documentation)Correct, appeal, and resubmit complex denials related to medical necessity, coding, bundling, or payer-specific rulesEnsure claims meet CMS, Medicaid, and commercial payer requirements for coverage, authorization, and documentationPerform detailed follow‑up on aged accounts, with emphasis on high‑balance or problematic claimsConduct root‑cause analysis for recurring denials and collaborate with coding or revenue integrity to prevent future issuesManage payer-specific work queues and maintain productivity and quality standardsCommunicate directly with payers to resolve underpayments, request reconsiderations, or escalate disputesMaintain a strong understanding of billing guidelines, including NCCI edits, LCD/NCD requirements, and revenue code usageEnsure all work adheres to HIPAA, CMS regulations, and organizational compliance standardsParticipate in internal audits and assist leadership in correcting workflow gaps or documentation issuesServe as an escalation point for Hospital Billing Specialist team membersProvide guidance, mentoring, and informal training to support skill development across the teamCollaborate with Revenue Cycle to identify trends, investigate issues, and resolve claims issuesAssist with updating reference materials, payer matrices, and departmental SOPsIdentify opportunities to streamline billing processes and improve clean claim ratesProvide feedback to leadership on system issues, payer trends, and workflow gapsAssist with testing and implementation of system updates, new payer rules, or operational changesMay require occasional overtime during high‑volume periods or special projectsThis role offers flexible remote work options, provided that all performance standards and job responsibilities are consistently metSkillsStrong working knowledge of UB‑04 billing standards, CPT/HCPCS, ICD‑10, and Medicare/Medicaid regulationsSkill in researching and resolving claim edits, authorization issues, and reimbursement discrepanciesProficiency with EHR and billing systems (e.g., Meditech, eCW, Medent) and clearinghouse platforms (Quadax)Excellent analytical and problem‑solving skillsStrong communication, documentation, and customer service abilitiesAbility to work independently with minimal supervision and manage competing prioritiesWork

FLSA7DAY- 8 Hours Day ShiftPosition Hours:0Samaritan is an Affirmative Action/Equal Opportunity Employer. Women, Minorities, Disabled, and Veterans are encouraged to apply.