Revenue Cycle Billing Specialist: Denials & Claims Expert

Outreach Community Health Centers; Milwaukee (WI); On-site; USD 42,000 - 64,000; Full time

Job summary

Outreach Community Health Centers is seeking a Healthcare Billing Specialist to coordinate claim submissions and manage denials. You will work with insurers, providers, and patients to ensure timely processing and accurate payments.

The role requires attention to detail, experience in healthcare billing, and strong Excel skills. The position supports the Finance department in a fast-paced environment and may involve annual education sessions.

Qualifications

• High School diploma or equivalent required.
• At least two years’ experience in healthcare billing and alternate payor reimbursement claims processing.
• Knowledge of insurance, managed care, PPO, FQHC billing and Milwaukee County systems preferred.
• Previous medical terminology and coding experience.

Responsibilities

• Submit claims with a goal of zero errors by verifying completeness and accuracy.
• Post insurance payments and adjustments by line item.
• Follow up on claim denials, identify root causes, and implement corrective actions.
• Utilize aging reports to prioritize unpaid claims older than 30 days.
• Coordinate medical records requests and respond to information requests from providers and/or insurers.
• Read and interpret EOBs to determine payment accuracy and patient liability.
• Meet with the Revenue Cycle Supervisor to discuss reimbursement issues and process improvements.
• Attend monthly staff meetings and required continuing education sessions.
• Perform other duties to support the Finance department.

Skills

Excel skills (VLOOKUP, Pivot Tables, 0

Billing knowledge

Communication skills

Analytical skills

Education

High School diploma or equivalent

Tools

EMR software

Practice Management software

Job description

Outreach Community Health Centers is seeking a Healthcare Billing Specialist to coordinate claim submissions and manage denials. You will work with insurers, providers, and patients to ensure timely processing and accurate payments.

The role requires attention to detail, experience in healthcare billing, and strong Excel skills. The position supports the Finance department in a fast-paced environment and may involve annual education sessions.