Medical Billing Specialist

Medical Billing Specialist

Tenderness Health Care | Shorewood, WI

Full-Time

Pay Range: $23–$25/hr based on experience

Shorewood — 3569 N Oakland Ave, Suite B, Shorewood, WI 53211

Milwaukee — 823 S Layton Blvd, Milwaukee, WI 53215

For more than 15 years, Tenderness Health Care has been committed to providing quality care while building a workplace where employees feel valued, respected, and supported.

As we continue to experience rapid growth and expand our healthcare services, we are creating new opportunities for talented professionals who want to grow with us.

We are looking for an A+ team player who takes pride in their work, values teamwork and accountability, and is excited to build a long-term career with an established and growing healthcare organization.

At Tenderness, your work matters, your contributions are appreciated, and there is opportunity to grow as we grow.

The Medical Billing Specialist will support billing, revenue-cycle, authorization, and related operational processes.

This position helps ensure services are billed accurately and timely, outstanding claims are followed through to resolution, authorizations and recertifications are properly tracked, and billing-related workflows remain organized.

The ideal candidate is detail-oriented, dependable, comfortable working across multiple systems, and able to take responsibility for tasks from beginning to completion.

• Prepare, review, and submit healthcare claims accurately and timely
• Review billing information for completeness and accuracy before submission
• Cross-check billable services against submitted claims
• Review billable hours for accuracy and completeness
• Identify services that have not yet been billed
• Monitor rejected, denied, unpaid, and underpaid claims
• Research billing issues and follow them through to resolution
• Correct and resubmit claims when necessary
• Follow up with insurance companies and payors regarding outstanding claims
• Review accounts receivable and aging reports
• Assist with payment posting and reconciliation
• Verify eligibility and applicable payer requirements as needed
• Confirm required authorizations are in place before billing
• Review EVV and service information for billing discrepancies
• Identify missing or incorrect information that could delay payment
• Maintain detailed and accurate billing notes
• Assist with denial management and payment follow-up
• Escalate unresolved billing issues when appropriate

• Prepare and maintain weekly billing reports
• Perform billing cross-checks and identify discrepancies
• Review billing activity to help ensure eligible services are captured
• Track outstanding claims and follow-up activity
• Monitor billing-related tasks through completion
• Review accounts receivable reports
• Identify recurring billing issues and trends
• Communicate billing concerns to the appropriate departments
• Assist with improving billing workflows and internal processes
• Help ensure billing deadlines and internal expectations are met

• Manage assigned clients through administrative portions of the referral and authorization process
• Track referrals through required administrative steps
• Assist with gathering information needed for prior authorization submissions
• Track pending prior authorizations
• Follow up on authorization requests and outstanding documentation
• Monitor authorization effective and expiration dates
• Assist with recertification tracking and administrative processing
• Identify missing documentation or information
• Communicate outstanding items to the appropriate team members
• Help prevent interruptions in service related to authorization issues
• Maintain accurate notes and status…