Insurance Billing Specialist

Ultipro; Shenandoah (IA); On-site; USD 36,000 - 48,000; Full time

Job summary

Ultipro is seeking a dedicated Medical Billing Specialist in Shenandoah, IA to review and submit clean claims, perform timely follow-ups, and manage aging accounts. Candidates with medical office or insurance billing experience will excel in coordinating with payers and internal departments to ensure accurate patient statements and timely payments.

Responsibilities include submitting paper claims when needed, addressing denials through reconsideration and appeals, and maintaining up-to-date

Qualifications

• Medical billing experience in a healthcare setting preferred.
• Experience with payer denials and appeals is a plus.

Responsibilities

• Review and submit clean claims for payment.
• Perform timely follow-up on accounts and maintain weekly goals.
• Review aging reports and follow up on aged balances.
• Work with payers on denials through processes including reconsideration and appeals.
• Complete training and examinations as required.

Skills

Medical Billing

Claims Processing

Payer Communications

Education

High School diploma or equivalent

Tools

EMR Software

Clearinghouse Submissions

Job description

1. Review and submit clean claim for payment

• Reviews and corrects all claim edits in the clearinghouse.
• Reviews and corrects all edits within the EMR software.
• Ensure proper secondary billing.
• Review and submit Paper claims with required attachments if appropriate.
• Verifies all unknown information with the appropriate department.
• Review and correct all Medicare claim edits for submission to WPS.
• Review and correct all Return to Provider claims.

3. Completes Timely Follow-Up.

• Reviews account balances to ensure accuracy.
• Achieves department weekly goal for follow-up.
• Works with payers on denials with processes including, but not limited to, phone call verifications, medical records submission, reconsideration and appeals.
• Ensures the proper and timely submission of patient responsibility to statement vendor.

4. Completes Regular Review of Aging.

• Reviews aging reports on a regular basis.
• Completes frequent follow up on aged accounts.
• Reports issues to direct supervisor.

5. Performs other duties as assigned.

• Submission of reconsideration and appeals for payer denials as required.
• Completes and passed all training and exams.

Qualifications

Education

Required

High School or better.

Experience

Preferred

Medical Office experience preferred

Insurance/Billing experience preferred

Equal Opportunity Employer
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