Insurance Billing Specialist

Crossing Rivers Health; Prairie du Chien (WI); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life Insurance

Short-term Disability

Paid Time Off

Retirement Plan with company match

Job summary

Crossing Rivers Health is seeking an Insurance Billing Specialist in Prairie du Chien, WI. This full-time days role handles review, edits, and submission of claims, with follow-up on unpaid claims and payer inquiries. The position requires 1–2 years in healthcare billing and EPIC experience, supported by strong communication and organizational skills.

A competitive benefits package accompanies the role. Relocation Grant opportunities are noted in the posting; this is a full-time, on-site role

Qualifications

• High School Graduate or General Education Degree (GED) is required.
• 1-2 years of healthcare billing experience preferred.
• 1-2 years of EPIC experience preferred.

Responsibilities

• Review, edit, and correct claims to ensure accuracy and readiness for submission.
• Submit claims to insurance carriers and intermediaries; handle secondary claims as required.
• Follow up on unpaid claims to ensure timely payment, via calls or payer portals.
• Respond to inquiries from patients and insurance companies; resolve issues.

Skills

Healthcare billing

Accounts receivable

Patient communication

Detail oriented

Organized

Reliability

Research skills

Education

High School Graduate or GED

Associate’s Degree in Business Related Field

Tools

EPIC

Microsoft Office

Job description

Description

Insurance Billing Specialist

Full Time Days

80 hours per pay period

Come join our team! Crossing Rivers Health provides competitive pay along with an excellent benefits package including medical, dental, vision; life insurance, short term disability, paid time off, a retirement plan w/company match, and more!

The Insurance Billing Specialist accurately and promptly reviews and updates claims needing manual intervention prior to claim submission, submits claims to insurance carriers, follows up on the status of unpaid claims, works denied claims to resolve any errors or provides necessary information to payers needed for disputing or resubmitting. This position requires routine problem solving and handles inquiries from both insurance carriers and patients, with a goal of account resolution.

Our core values are practiced and exhibited throughout the organization in our actions and in services provided.

Joy : Unity : Integrity : Compassion : Excellence

Crawford County Relocation Opportunity - Talent Recruitment Grant

Crossing Rivers Health is excited to partner with Driftless Development, Inc. to secure the newly awarded Talent Recruitment Grant by Wisconsin Economic Development Corporation (WEDC). Come Home to River Country is an initiative designed to attract and retain talent by offering a relocation incentive for out-of-state households moving to Crawford County, Wisconsin. Click here for more information. Driftless Development

Essential Job Functions

• Reviews, edits, and corrects claims, as necessary, checking for accuracy and readiness of claims to be submitted through the electronic health record (EPIC).
• Prepares and submits claims to insurance carriers and intermediaries, i.e. releasing electronic claims, printing paper claims, and/or secondary claim as required per individual payer.
• Works with various departments to ensure that held claims will be released to the payer within timely filing limits.
• Performs follow-up procedures, inquiring on the status of unpaid claims via phone call or various payer portals, to ensure timely payment of insurance claims.
• Responds to routine patient and insurance company inquiries and problems.
• Researches denials/non-covered charges and re-submits or appeals, as necessary.
• Reviews late charges for re-billing or adjustment of claims, as necessary.
• Reviews insurance eligibility or coverage changes to ensure accuracy of information, resolve any outstanding issues, and rebill claims when necessary.
• Updates necessary changes to patient demographics and/or insurance information.
• Reviews accounts with insurance credit balances and determines if a refund or other action is necessary to settle account.
• Accommodates patient requests and inquiries promptly and courteously, answering incoming calls to the Business Office, educating patients on their financial responsibilities to the organization, accepting payment, setting up payment plans, etc.
• Performs other duties as deemed necessary for the continued viability and success of the department and organization as a whole.
• Other job duties and responsibilities as assigned to effectively meet the needs of the patients, the department, and the organization as a whole.

Competencies

• Accountability – Ability to accept responsibility and account for his/her actions.
• Communication – The ability to get one’s ideas across to others through oral or written means and to understand the ideas of others through effective listening skills.
• Customer Oriented – Ability to take care of the customers’ needs while following company procedures.
• Detail Oriented – Ability to pay attention to the minute details of a project or task.
• Organized – Possessing the trait of being organized or following a systematic method of performing a task.
• Ethical – Ability to demonstrate conduct conforming to a set of values and accepted standards.
• Accuracy – Ability to perform work accurately and thoroughly.
• Reliability – The trait of being dependable and trustworthy.
• Research Skills – Ability to design and conduct a systematic, objective, and critical investigation.

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Requirements

Education

• High School Graduate or General Education Degree (GED): Required
• Associate’s Degree (two year college or technical school) Preferred, Field of Study: Business Related

Experience

• 1-2 years of healthcare billing experience preferred
• 1-2 years of EPIC experience preferred

Computer Skills

• Microsoft Office proficiency