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. Our team members enjoy a robust benefits package including: - Paid Time Off (PTO) - Comprehensive Health Benefits - Medical, Dental & Vision - 401k with company match - Tuition reimbursement 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. - 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. - This is a fully remote opportunity. Qualifications - H.S. Diploma or GED required - Associate Degree or coursework in Accounting, Finance, Healthcare Administration, or related field preferred - 0-1 years of experience in medical billing, reimbursement, claims processing, or accounts receivable required - Experience with payer reimbursement policies, claim adjudication, and healthcare revenue cycle operations preferred Knowledge, Skills and Abilities - 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. We know it’s not just about finding a job. It’s about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers. This 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.

Job Summary The Underpayment & Overpayment Collector – Healthcare (REMOTE) is responsible for the timely and efficient resolution of underpaid and overpaid accounts. This role involves managing account follow-up, analyzing trends, collaborating with internal departments, and ensuring accurate reconciliation of account balances. The PCCM Collector assists in optimizing revenue cycle processes and maintaining compliance with contractual agreements. As a Payment Compliance Collector at Community Health Systems (CHS) - PCCM, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. Essential Functions - Manages account follow-up for underpaid and overpaid claims, escalating unresolved issues internally as needed to achieve resolution. - Reconciles account balances and adjustments to ensure accurate financial status and compliance with contractual terms. - Resolves underpayments by engaging in daily communication with payers and negotiating payment discrepancies. - Identifies and analyzes trends in underpayments, overpayments, denials, and revenue opportunities to recommend process improvements. - Evaluates and interprets contract reimbursement details, providing feedback and insights to the department to enhance revenue cycle performance. - Collaborates with financial and clinical departments to address account discrepancies and ensure effective revenue management. - Reviews contract validation, updates, and provides interpretation to support accurate claim processing and collections. - Ensures thorough and accurate validation of account analysis before distribution, maintaining compliance with policies and procedures. - Performs other duties as assigned. - Complies with all policies and standards. - This is a fully remote position Qualifications - H.S. Diploma or GED required - Associate Degree or higher preferred - 1-2 years of experience in healthcare collections, revenue cycle, or contract management required - Familiarity with payer contracts and healthcare reimbursement methodologies preferred - Experience in hospital insurance collections strongly preferred - UB-O4 experience strongly preferred Knowledge, Skills and Abilities - Strong analytical and problem-solving skills. - Proficient in understanding and interpreting payer contracts and reimbursement terms. - Effective communication and negotiation skills. - Ability to work independently and manage multiple priorities in a fast-paced environment. - Proficiency in healthcare billing software, Google Suite, and Microsoft Office Suite, especially Excel. - Attention to detail and high degree of accuracy in reconciliation and analysis. We know it’s not just about finding a job. It’s about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.

• Monitor and maintain accounts within assigned portfolio (large accounts). • Contact clients via verbal and written communication for payment of past due invoices. • Provide information and/or documentation to both internal and external clients. • Interact with Collections Manager and Operation Designees to resolve client issues. • Maintain current and accurate account notes in collections software. • Provide updates on accounts to Collections Manager, Operations and Sales as needed. • Work daily follow up queue in collections software. • Notify the Collections Manager of negative payment patterns. • Facilitate and/or attend conference calls specific to collections activity on client accounts. • Resolve cash discrepancies on client accounts by research in Oracle of payment application. • Process credit card payments. • Complete side projects/ task as assigned by Collections Manager

• Manage the full cycle from order entry to cash receipt, ensuring accuracy and efficiency • Ensure timely and accurate generation and delivery of customer invoices • Supervise the application of incoming payments to customer accounts • Oversee collection activities, follow up on overdue accounts, and reduce DSO (Days Sales Outstanding) • Prepare and maintain reports on customer collection status and outstanding receivables • Send Collection reports on a timely basis to BU/NECI Finance • Investigate and resolve billing disputes, short payments, and customer deductions • Coordinate with stakeholders to gather additional details with respect to collections or credit management transactions • Create collection entry in SAP post confirmation from stakeholders • Respond to queries in a timely and accurate manner • Maintain strong relationships with key customers to ensure satisfaction and timely payment • Adhere to process defined Service Level Agreements (SLA) and Turn Around time (TAT)