Billing Specialist - Part-Time

Outreach Community Health Centers, Inc; Milwaukee (WI); On-site; USD 42,000 - 64,000; Full time

Job summary

Outreach Community Health Centers is hiring for a healthcare billing specialist in Milwaukee, WI. The role collaborates with insurance companies, providers, and patients to process and pay claims, review denials, and manage aging accounts.

Qualified candidates have at least two years of healthcare billing experience, strong Excel skills, and familiarity with EMR/PM software. A detail-oriented, fast-paced professional mindset is essential for success in this role.

Qualifications

• High school diploma or equivalent required.
• At least two years’ experience in healthcare billing and alternate payor reimbursement processing.
• Knowledge of insurance, managed care, PPO, FQHC billing and Milwaukee County systems preferred.
• Prior medical terminology and coding experience.

Responsibilities

• Submit claims with a goal of zero errors by verifying accuracy before transmission.
• Post insurance payments and adjustments by line item.
• Follow up on claim denials, identify root causes and implement corrective actions.
• Utilize aging reports and work queues to prioritize unpaid claims over 30 days.
• Coordinate medical records requests and information from providers/insurers.
• Read and interpret EOBs to determine payment accuracy and patient liability.
• Regularly meet with the Revenue Cycle Supervisor to discuss reimbursement issues and process improvements.
• Attend monthly staff meetings and required continuing education sessions.
• Perform other duties to support the Finance department.
• Handle reimbursement processes.

Skills

Advanced Excel

Excellent communication

Analytical skills

Multi-tasking

Education

High School diploma or equivalent

2+ years healthcare billing experience

Knowledge of insurance billing & Milwaukee County systems

Medical terminology experience

Tools

EMR software

Practice Management software

Job description

Position Summary

Working directly with the insurance company, healthcare provider, and the patient to get a claim processed and paid. You will be required to review and appeal all unpaid and denied claims. This position requires an individual with an extraordinary level of attention to detail and the ability to multi-task. This is a high volume, fast paced and exciting environment

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

• Claims Submission: Ensure all claims are submitted with a goal of zero errors by verifying completeness and accuracy prior to transmission.
• Payment Posting: Accurately post all insurance payments and adjustments by line item.
• Denial Management: Timely follow up on insurance claim denials, exceptions, or exclusions; identify root causes and implement corrective actions.
• Aging Reports: Utilize monthly aging accounts receivable (A/R) reports and work queues to prioritize and follow up on unpaid claims aged over 30 days.
• Documentation: Coordinate medical records requests and complete additional information requests from providers and/or insurance companies.
• Communication: Read and interpret insurance explanation of benefits (EOBs) to determine payment accuracy and patient liability.
• Collaboration: Regularly meet with the Revenue Cycle Supervisor to discuss reimbursement issues, billing obstacles, and process improvements.
• Professional Development: Attend monthly staff meetings and required continuing educational sessions.
• Additional Duties: Perform other duties as assigned to support the Finance department.
• Reimbursement

Minimum Qualifications (Knowledge, Skills, and Abilities)

Education & Experience

• High School diploma or equivalent required.
• At least two years’ experience in healthcare billing, and alternate payor reimbursement claims processing.
• Knowledge of insurance, managed care, PPO, FQHC billing and Milwaukee County systems are preferred.
• Previous medical terminology and coding experience.

Knowledge, Skills, and Abilities

• Advanced proficiency in Microsoft Excel (specifically VLOOKUP, Pivot Tables, and advanced formulas) required. Experience with Electronic Medical Record (EMR) and Practice Management (PM) software is a plus.
• Excellent oral, written, and presentation communication skills. Ability to communicate complex billing information clearly to patients, medical staff, and payors.
• Ability to establish and maintain effective working relationships with patients, medical staff, coworkers, and the public.
• Strong analytical skills with the ability to resolve discrepancies and appeal denied claims effectively.

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