Payer Liaison & Claims Follow-Up Specialist

Rogers Behavioral Health, Inc.; Town of Oconomowoc (WI); On-site; USD 40,000 - 60,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) retirement plan

Life/disability insurance

Flex spending accounts

Tuition reimbursement

Health and wellness program

Employee assistance program (EAP)

Job summary

Rogers Behavioral Health, Inc. is seeking a Claims Specialist to follow up with commercial and government payers to resolve billing issues and secure timely reimbursement.

The role involves examining denials, communicating with payers, and identifying root causes to reduce accounts receivable while maintaining HIPAA compliance and professional standards. Candidates should have at least one year of experience in medical billing or insurance follow-up and be proficient with payer guidelines and

Qualifications

• High school diploma or equivalent.
• Minimum of one year of relevant experience in mental health or medical insurance billing and/or collections.
• Demonstrated knowledge of third-party payer guidelines, reimbursement, follow-up, and collections.
• Demonstrated knowledge of claims review and analysis; ICD-10, CPT, and HCPCS coding; and medical terminology.
• Effective communication, leadership, organizational, and problem-solving skills.
• Ability to manage multiple tasks and projects simultaneously.
• Ability to analyze data, identify improvement, and implement change.
• Strong interpersonal and customer service skills.

Responsibilities

• Examine denied and underpaid claims to determine discrepancies.
• Follow up with payers to resolve issues and secure timely reimbursement.
• Identify root causes of denials and coordinate corrective actions.
• Maintain HIPAA-compliant handling of patient information.
• Participate in quality improvement and communicate trends to management.
• Support hospital goals with professional teamwork and accurate documentation.

Skills

Payer guidelines knowledge

Billing & collections

Denials analysis

HIPAA compliance

Communication & problem-solving

Education

High school diploma or equivalent

Tools

Microsoft Word

Excel

Outlook

Teams

OneNote

Oracle Health Patient Accounting

ICD-10/CPT/HCPCS terminology

Job description

Rogers Behavioral Health, Inc. is seeking a Claims Specialist to follow up with commercial and government payers to resolve billing issues and secure timely reimbursement.

The role involves examining denials, communicating with payers, and identifying root causes to reduce accounts receivable while maintaining HIPAA compliance and professional standards. Candidates should have at least one year of experience in medical billing or insurance follow-up and be proficient with payer guidelines and