Front End Specialist

Aprima; Town of Texas (WI); On-site; USD 42,000 - 64,000; Full time

Job summary

A healthcare technology company based in Wisconsin seeks an experienced individual for claims processing. The role involves managing electronic and paper claims, ensuring HIPAA compliance, and providing feedback on accounts. Candidates should possess a high school diploma and preferably two years of experience in physician billing, with strong skills in communication, detail orientation, and problem-solving. This position offers the opportunity to work within a supportive team environment, meeting productivity and quality standards.

Qualifications

• Preferably two years’ experience in physician professional billing.
• Familiarity with insurance billing requirements and coding (CPT & ICD10).
• Ability to maintain productivity and quality standards.

Responsibilities

• Process claims as per client requirements.
• Manage and work on rejected claims.
• Provide feedback to management about account occurrences.
• Maintain confidentiality and HIPAA compliance.
• Attend meetings and participate in committees as required.

Skills

Detail-oriented

Analytical skills

Communication

Customer service

Problem Solving

Time management

Education

High school diploma/GED

Tools

MS Excel

MS Word

Aprima PM practice management system

GE Centricity Business system

Job description

Overview

Maintenance of filing electronic & paper claims as well as managing rejections. Report rejection trends to team leads/managers.

Responsibilities

• Claims Processing as per client requirements
• Work Rejected & Queued Rejections
• Provide feedback to team lead regarding any positive & negative occurrences on accounts
• Maintain strict confidentiality within medical practice and HIPAA compliance.
• Maintain productivity standards and goals set by the department and/or manager.
• Maintain standard quality measures and goals.
• Attend Meetings as required and/or participate in various committees as required
• Other duties as assigned by, Team Lead, Manager, Director, VP RCM.

Required Skills

• High school diploma/GED
• Preferably two years’ prior experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication, including but not limited to:
• Explanation of Benefit forms (EOB)
• Credit balances (discounts and refunds)
• Insurance carrier billing requirements
• Collections
• Familiarity of payer provider enrollment
• CPT & ICD10 Coding

Core Competencies

• Accountability and Self-Management
• Must be detail-oriented and organized
• A self – starter capable of tracking to deadlines and meeting goals with little supervision required
• A high level of analytical and problem solving skills is expected
• Team Player
• Ability to work autonomously and as a team player
• Communication
• Excellent communication, customer service, and organizational skills
• Strong verbal and written communications
• Innovation and Problem Solving
• Attention to detail and moderate analytical and problem solving skills is expected
• Computer Skills
• Must possess general office skills and computer knowledge
• Strong working knowledge of the Aprima PM practice management system and/or GE Centricity Business system and coordinating modules, is preferred
• MS Excel Spreadsheet software, MS Word Processing software

Physical Demands

• May require sitting for long periods of time; also, stooping, bending, and reaching for files and supplies.
• Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, and run a copier and other office equipment as necessary.
• Employee must participate to help maintain the desirable work environment created by the management and company officials.

Equal Opportunity

This employer is an Equal Opportunity Employer. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.