Pediatric Billing Resolution Specialist

Children's Wisconsin; West Allis (WI); On-site; USD 42,000 - 64,000; Full time

Job summary

Children’s Wisconsin is a nationally recognized health system dedicated to the health and well-being of children. This role focuses on researching and resolving professional billing overpayments/underpayments and reviewing underpayments to maximize reimbursement.

You will collaborate with payer contracting and coding teams, verify insurance data, and follow up on inquiries with patients and payers. A background in medical billing and Epic Resolute is preferred.

Qualifications

• Working knowledge of medical terminology, ICD-10 and CPT.
• Excellent verbal and written communication skills.
• Ability to work independently with minimal supervision.
• Interpersonal skills to resolve billing issues with patients and payers.
• Microsoft Office proficiency and basic technology skills.

Responsibilities

• Investigates credit balances, reviews refunds, and protects financial interests.
• Maintains knowledge of billing guidelines for Professional Billing.
• Collaborates with Payer Contracting and understands managed care policies.
• Identifies coding issues and works with leadership to resolve.
• Verifies patient insurance information and tracks payments/denials.
• Analyzes improper credits and communicates issues to management.
• Submits correspondences and appeals to maximize reimbursement.
• Maintains productivity and quality standards.

Skills

Medical terminology

ICD-10 knowledge

CPT coding

Communication skills

Microsoft Office

Independent work

Team collaboration

Education

High School diploma or GED

Tools

Epic Resolute

Job description

Children’s Wisconsin is a nationally recognized health system dedicated to the health and well-being of children. This role focuses on researching and resolving professional billing overpayments/underpayments and reviewing underpayments to maximize reimbursement.

You will collaborate with payer contracting and coding teams, verify insurance data, and follow up on inquiries with patients and payers. A background in medical billing and Epic Resolute is preferred.