Claims Advocate: AR Follow-Up & Billing

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

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.