Healthcare Billing Specialist

Role: Healthcare Billing Specialist
Duration: 8 Months (Contract expected to extend)
Location: Nashville TN (On-Site)

• Key TennCare encounters into PTBMIS accurately and within established timelines.
• Post payments write-offs and maintain revenue tracking.
• Update billing addresses and maintain provider information.
• Maintain HIPAA compliance and confidentiality standards.
• Prepare monthly billing reports and supporting documentation.
• Provide operational billing support to ensure continuity of services.

• Research billing discrepancies payment issues claim denials and reconciliation differences.
• Identify root causes of billing errors and recommend corrective actions.
• Review billing trends and identify recurring issues impacting reimbursement.
• Document manual workarounds and standard operating procedures.
• Perform reconciliations between billing activity remittances and financial reports.
• Monitor billing timelines to support timely filing requirements.

• Evaluate current billing workflows and identify opportunities for automation.
• Support implementation planning for a future third-party billing solution.
• Participate in workflow mapping and documentation.
• Plan coordinate and execute testing validation and documentation for new billing processes system enhancements and future third-party billing solutions.
• Recommend efficiencies that reduce manual data entry and duplicate work.
• Develop and maintain process documentation and training materials.
• Participate in special projects supporting modernization of laboratory billing operations.
• Collaborate with laboratory staff fiscal administration staff procurement informatics and external stakeholders to resolve billing issues and support billing process improvements.

• Medical billing Medicaid or healthcare revenue cycle operations
• Claims processing or encounter management
• Microsoft Excel (intermediate level)
• Investigating billing discrepancies
• Process improvement or workflow analysis
• Data validation and quality assurance
• Maintaining confidential health information (HIPAA)
• Learning multiple software systems
• Following detailed written procedures
• Working independently while managing competing priorities

• PTBMIS
• StarLIMS
• Availity
• Tennessee Medicaid (TennCare)
• Healthcare billing software
• State government financial processes

• Experience in healthcare billing medical office administration finance laboratory operations or related field.
• Strong analytical and problem-solving skills.
• Excellent organizational and time management abilities.
• Ability to identify process improvements and recommend practical solutions.
• Strong written and verbal communication skills.
• High attention to detail with demonstrated accuracy.
• Ability to maintain confidentiality and handle sensitive information.

Required Experience:

IC