Medical Billing Specialist

Mile Bluff Medical Center; Mauston (WI); On-site; USD 40,000 - 50,000; Full time

Job summary

Mile Bluff Medical Center in Mauston, Wisconsin, is seeking a Medical Billing Specialist for a full-time position. The Medical Billing Specialist will accurately prepare and follow up on medical claims, ensuring compliance with healthcare regulations and effective communication with providers and patients.

The ideal candidate will have at least a high school diploma and 1+ years of experience in the medical industry, with familiarity in insurance guidelines and EHR systems. This role requires daily on-site presence with no remote work options.

Qualifications

• High school diploma or equivalent required.
• 1+ years of related work experience required.
• Experience working in the medical industry is preferred.

Responsibilities

• Prepare, submit, and transmit medical claims to payers.
• Review documentation and charges for accuracy.
• Follow up on unpaid or rejected claims.

Skills

Insurance claims experience

Attention to detail

Communication skills

Analytical skills

Education

High school diploma or equivalent

Tools

Electronic health records (EHR)

Billing software

Job description

General Information

Job title: Medical Billing Specialist

Schedule: Full-time, 80 hours per pay period; Monday - Friday, 8:00am - 4:30pm

Position is not eligible for remote work. Must report on-site daily.

Weekend rotation: No Weekends

Holiday rotation: No Holidays

Position Summary

The Medical Billing Specialist is responsible for accurately preparing, submitting, and following up on medical claims to insurance companies and patients. This role ensures timely reimbursement, compliance with healthcare regulations, and effective communication with providers, payers, and patients.

Position Responsibilities

• Prepare, submit, and transmit clean medical claims to commercial, Medicare, and Medicaid payers (electronic and paper)
• Review and resolve accounts and pre claim edits.
• Verify patient insurance coverage and benefits.
• Review documentation and charges for accuracy and compliance.
• Monitor accounts receivable and follow up on outstanding balances.
• Follow up on unpaid, denied, or rejected claims and resolve billing issues.
• Review and reconcile account credit balances.
• Identify and correct billing errors to prevent claim rejections.
• Communicate and collaborate with coding, denial management specialists, insurance companies, patients, clinical staff and healthcare providers regarding billing inquiries or issues to ensure accurate charges, billing, and reimbursement.
• Maintain compliance with HIPAA, Medicare, Medicaid, and payer guidelines.
• Assist with patient billing questions and patient payments.
• Interpret EOBs and remittance advice.
• Maintain accurate billing records and documentation.
• Support audits and compliance initiatives when documentation.
• Perform other duties as requested.

Position Requirements

• High school diploma or equivalent required.
• 1+ years of related work experience required.
• Experience working in the medical industry is preferred.
• Familiarity with insurance guidelines, EOBs, and claim adjudication processes.
• Proficiency with electronic health records (EHR) and billing software.
• Exceptional accuracy and attention to detail required.

Knowledge, Skills, & Abilities

• Intermediate proficiency with computers is required.
• Experience in insurance claims is required.
• Knowledge of CPT, ICD-10, and HCPCS coding systems.
• Strong quantitative and analytical competency.
• Self-starter with excellent interpersonal communication and problem-solving skills.