AR Follow-Up and Billing Specialist

Outreach Community Health Centers; Milwaukee (WI); On-site; USD 42,000 - 56,000; Full time

Job summary

Outreach Community Health Centers seeks a Revenue Cycle Specialist to ensure accurate processing of insurance claims and timely payments. You will review denials, post payments, and coordinate with providers and patients.

Ideal candidates have a high school diploma and 2+ years in healthcare billing, familiarity with Medicare/Medicaid, and strong written and verbal communication. This full-time on-site role offers teamwork and opportunities to improve billing outcomes.

Qualifications

• High school diploma required with at least two years in healthcare billing and alternate payor claims processing.
• Experience with medical terminology and coding is required.
• Strong communication skills, including oral, written, and presentation abilities.
• Experience with Medicare and Medicaid claims is preferred.
• Familiarity with insurance processes, managed care, PPOs, FQHC billing, and Milwaukee County systems is highly desirable.
• Ability to multitask and work effectively under pressure.
• Capable of building positive relationships with patients and medical staff.

Responsibilities

• The primary duty is to work with insurance companies, providers, and patients to ensure claims are processed and paid.
• Review and appeal unpaid and denied claims.
• Submit claims with a goal of zero errors and verify completeness prior to submission.
• Accurately post insurance payments by line item.
• Follow up on denials, exceptions, or exclusions in a timely manner.
• Read and interpret insurance explanations of benefits.
• Utilize aging reports to follow up on unpaid claims over 30 days.
• Coordinate medical records requests from providers and/or insurers.
• Meet with the Revenue Cycle Supervisor to discuss reimbursement issues.
• Attend monthly staff meetings and continuing education sessions.
• Perform additional duties as assigned.
• Experience filing claim appeals to maximize reimbursement.

Skills

Healthcare billing

Medical terminology

Communication skills

Claims processing

Insurance claims follow-up

Education

High school diploma

Job description

In order to be considered for this position, candidates must meet the following qualifications: Education and/or Experience – Required Qualifications

• High school diploma required, with a minimum of two years of experience in healthcare, billing, and alternate payor reimbursement claims processing.

• Previous experience with medical terminology and coding is required.

• Strong professional communication skills, including oral, written, and presentation abilities.

• Experience with Medicare and Medicaid claims is preferred.

• Familiarity with insurance processes, managed care, PPOs, FQHC billing, and Milwaukee County systems is highly desirable.

• Ability to work effectively under pressure and manage multiple priorities.

• Demonstrated ability to establish and maintain positive working relationships with patients, medical staff, coworkers, and the general public.

• Proficient in reading, writing, and communicating clearly and effectively in both verbal and written forms.

Job Purpose and Reporting Structure

The primary responsibility of this position is to work directly with insurance companies, healthcare providers, and patients to ensure claims are processed and paid. You will be required to review and appeal all unpaid and denied claims. This position demands an extraordinary level of attention to detail and the ability to multi-task in a high-volume, fast-paced, and exciting environment.

This position will report directly to the Revenue Cycle Supervisor. Essential Duties and Responsibilities

• Ensure all claims are submitted with a goal of zero errors.
• Verify the completeness and accuracy of all claims prior to submission.
• Accurately post all insurance payments by line item.
• Follow up timely on insurance claim denials, exceptions, or exclusions.
• Meet deadlines.
• Read and interpret insurance explanation of benefits.
• Utilize monthly aging account receivable reports and/or work queues to follow up on unpaid claims aged over 30 days.
• Make necessary arrangements for medical records requests and completion of additional information requests from providers and/or insurance companies.
• Regularly meet with the Revenue Cycle Supervisor to discuss and resolve reimbursement issues or billing obstacles.
• Regularly attend monthly staff meetings and continuing educational sessions as required.
• Perform additional duties as assigned.
• Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.

Considerations & Statement

Outreach Community Health Centers requires employees in certain departments to be fully vaccinated against MMR (Measles, Mumps, Rubella), Varicella (Chickenpox), and Influenza.

Outreach Community Health Centers, Inc. is an Equal Opportunity Employer