Billing Specialist

The Billing Specialist is responsible for retrieving all billable charges, timely submission of claims, follow‑up on unpaid claims, and answering patient questions regarding their statements within the OCHIN Epic System. The role covers all payers – Medicare, Medicaid, managed care, commercial insurance, workers’ compensation, and private pay. The specialist maximizes revenues and cash flow by completing tasks promptly and efficiently, maintaining collections, and providing excellent customer service to internal and external customers.

• Retrieve all billable charges within 72 hours.
• Review, resolve, and bill all outstanding statuses promptly.
• Direct contact with patients to resolve all inquiries on their accounts.
• Monitor patient account activity through queries and statement review.
• Maintain the AR Aging Report to achieve department goals.
• Resolve follow‑up issues independently related to work assignments.
• Re‑process and follow up on all denials and system‑rejected claims.
• Process appeals promptly according to payer contract.
• Process all patient and insurance refunds.
• Run reports using OCHIN Epic.
• Document all accounts thoroughly.
• Assist in other department projects during decreased workload.
• Contribute to the Billing Department team with a positive attitude, respectful interaction, innovative ideas, efficiency, and ethical behavior.
• Participate in educational activities and attend staff meetings.
• Maintain strict confidentiality; adhere to all HIPAA and PHI guidelines/regulations.

• Minimum 3+ years in a physician or hospital collection setting; knowledge of ICD‑10, CPT, and HCPC codes.
• Knowledge of insurance carriers (Medicare, Medicaid, managed care, commercial, workers’ compensation) and reimbursement schemes, co‑insurance, deductibles, contractual adjustments, and sliding fee schedules.
• Working knowledge of OCHIN Epic and Microsoft Office.
• Strong interpersonal and communication skills; ability to work effectively in a team‑oriented environment.
• High attention to detail and ability to multitask.
• Hours and travel may vary based on organizational needs.

• Minimum education:
  
  High School Diploma (college coursework highly preferred).
• Minimum 3 years of experience in an FQHC, clinic, physician’s office, or hospital setting.

Milwaukee Health Services, Inc. is an equal opportunity employer.

Milwaukee Health Services, Inc. does not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or veteran status.