Billing Specialist

The Billing Specialist position manages and executes all aspects of Third-Party Payer billing and financial tracking.

• Prepares and submits clean claims to Third Party Payers keeping within the expectations of the billing cycle to remain 7-10 days.
• Maintains information on billing procedures by client and by payer.
• Researches and resolves client billing issues with Third Party Payers.
• Performs various collection actions including review of claim denials to determine if there is a billing error that must be resolved or working with co-workers to determine the necessary steps to obtain claim payment.
• Follows all insurance policy and regulations.
• Performs daily follow-up of claims, including resolution of any billing errors.
• Performs daily task assignments to work various requests from multiple departments.
• Processes rejections and denials to determine if the claim needs to be corrected and if applicable taking the action to submit a corrected claim.
• Communicate with clinical staff when errors are identified that will result in billing errors and/or denials.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Excellent oral, written and interpersonal communications skills.
• Consistent and regular attendance is a requirement of the position.

• Performs any other tasks assigned by management.

Not applicable.

Minimal.

This is largely a sedentary role, with frequent sitting and computer keyboarding (10-key) required. Some lifting (up to 35 pounds), stooping and bending are required.

• High school diploma or equivalent.
• Coursework and/or experience in medical and/or health insurance billing, medical records management.

• At least two years of previous medical insurance, billing, or claims processing related experience.
• Experience and strong knowledge of insurance procedures, reimbursement, contracts, and insurance appeal are preferred. CPT and ICD-10 certification a plus.

• Strong keyboarding and computer skills including MS Office (Word and Excel) experience at an intermediate level. 10-key data entry proficiency.
• Knowledge of basic medical coding and third-party operating procedures and practices, as well as knowledge of financial concepts.
• Experience working with basic office machinery and equipment, including computers, copiers, fax machines, multi-line phone systems, etc.
• Knowledge of HIPAA privacy and security rules and regulations.
• Excellent interpersonal skills, with the ability to communicate effectively with others.
• Strong organizational skills, with the ability to multi-task and meet deadlines.
• Demonstrates initiative, with the ability to manage self and workload.
• Strong analytical and problem-solving abilities. Good mathematical aptitude.
• Exemplary customer service focus, for both internal and external clients.
• Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere.
• Displays professionalism and represents organization in a professional manner.
• Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPAA guidelines.

• Must be 18 years old or older.
• This position is based in Green Bay WI. Hybrid after training is complete.