Billing Representative

Healthrise

Billing Representative managing day-to-day billing activities for Hospital and Medical Group claims. Resolving claim issues and ensuring compliance with payer guidelines for timely operations.

Posted 7/10/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-LevelWebsite

About the role

Key responsibilities & impact

Performs day-to-day billing activities for Hospital (HB) and/or Medical Group (PB) claims, including claim generation and transmission
Responsible for primary, secondary, and tertiary billing, resolving claim edits and rejections, and ensuring claims are transmitted in compliance with payer guidelines
Serves as part of the Billing team to ensure timely, accurate, and compliant billing operations
Identifies routine billing issues and resolves or escalates them as appropriate
Maintains working knowledge of state and federal laws related to insurance contracts and payer billing timelines
Investigates and addresses overpayment and underpayment accounts to optimize reimbursement
Applies payer rules, contracts, schedules, and related data to ensure claims are billed accurately and timely
Researches payer trends and provides feedback to improve billing accuracy and operational efficiency
Tracks and reports denial types and root causes, recommending process improvements
Analyzes, categorizes, and resolves claim rejections from commercial, government, and managed care payers
Documents all actions and follow-up activities in the patient accounting system
Responds to patient and payer inquiries or refers them appropriately
Prepares and submits reports documenting billing trends, outcomes, and claim activity
Interprets data, draws conclusions, and reviews findings with supervisor
Cross-trains in various functions to enhance service delivery
Maintains knowledge of applicable federal, state, and local laws and regulations
Performs other duties as assigned

Requirements

What you’ll need

High school diploma or Associate degree in Accounting, Business Administration, or a related field
Minimum of two (2) to three (3) years of experience in revenue cycle medical billing, insurance follow-up, and denial management within one of the following settings: Hospital or clinic, Health insurance company or managed care organization, Healthcare financial services environment
Equivalent combination of education and experience may be considered
Experience in a complex, multi-site healthcare system preferred
Excellent written and verbal communication skills
Strong organizational and time-management skills with high attention to detail and accuracy
Strong interpersonal and customer service skills
Basic proficiency in Microsoft Office (Outlook, Word, PowerPoint, Excel)
Completion of regulatory and mandatory certifications preferred
Comfortable working in a collaborative, shared-leadership environment
Previous experience with Global Partner vendors preferred
Experience using Epic
Familiarity with CPT, ICD-10, and HCPCS coding
Strong problem-solving skills
Ability to work independently, meet deadlines, and maintain high attention to detail
Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or equivalent certification preferred

Benefits

Comp & perks

Health insurance
401(k) matching
Flexible work hours
Paid time off
Remote work options

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Claim GenerationClaim TransmissionBilling OperationsPayer Guidelines ComplianceData AnalysisReimbursement OptimizationClaim Rejection ResolutionPatient Accounting System DocumentationBilling Trend ReportingInsurance Follow-Up

Soft Skills

Excellent Communication SkillsStrong Organizational SkillsTime-Management SkillsInterpersonal SkillsCustomer Service Skills

Certifications

Certified Professional Biller (CPB)Certified Medical Reimbursement Specialist (CMRS)