Medical Billing & Revenue Cycle Specialist

Milwaukee Health Services; Milwaukee (WI); On-site; USD 45,000 - 65,000; Full time

Job summary

Milwaukee Health Services is seeking a Billing Specialist to manage claims and payment submissions across multiple payer types. You will focus on timely submission, follow-up, and resolving denials to maximize revenue and cash flow.

Responsibilities include working in the Charge Review and Claim Edit queues, researching denials, ensuring HIPAA compliance, and maintaining accurate notes in the EHR. A minimum of 2 years in revenue cycle is required.

Qualifications

• 2+ years revenue cycle experience in a medical setting.
• Knowledge of ICD-10, CPT, and HCPCS codes.
• HIPAA and PHI compliance knowledge.
• Strong interpersonal and communication skills.
• High attention to detail and multitasking ability.

Responsibilities

• Resolve all charges in the Charge Review Work Queue daily.
• Resolve all assigned claims in Claim Edit Work Queue daily.
• Resolve all payor rejections in the Follow Up Work Queue within 10 working days.
• Research and rebill/resolve all claim denials within 60 days of denial.
• Research and rebill all claims with no response from the payer within 60 days of the date billed.
• Monitor AR days for assigned departments, keeping AR days ≤ 45.
• Independently work to resolve claim denials to obtain payment.
• Process appeals within payer contract timely filing requirements.
• Research credit balances to determine if a refund is required and submit refund requests.
• Document actions on accounts in the EHR with clear notes.
• Contribute to the Billing Department team with professionalism and ethics.
• Participate in educational activities and team meetings.
• Maintain confidentiality in line with HIPAA regulations.

Skills

Revenue cycle experience

Attention to detail

Teamwork / interpersonal skills

HIPAA/PHI compliance

Education

High School Diploma

Tools

EHR system

Job description

Milwaukee Health Services is seeking a Billing Specialist to manage claims and payment submissions across multiple payer types. You will focus on timely submission, follow-up, and resolving denials to maximize revenue and cash flow.

Responsibilities include working in the Charge Review and Claim Edit queues, researching denials, ensuring HIPAA compliance, and maintaining accurate notes in the EHR. A minimum of 2 years in revenue cycle is required.