Accounting Assistant/Billing Specialist

FDLC•Fond du Lac, WI

1d•$21 - $27

About The Position

The Accounting Assistant/Billing Specialist verifies insurance eligibility and enters financial information into the computer system, determines clients’ maximum monthly liability and payment amounts, and confirms insurance coverage for outpatient and inpatient clients. The role obtains releases, prior authorizations, and insurance information required for inpatient billing. The position handles billing, collections, and reimbursements for Children’s Long Term Support services, Birth-3 services, outpatient and inpatient charges, and private-pay services. Duties include running and checking billing edit reports, submitting and resubmitting claims to primary insurers, billing secondary and tertiary insurers in paper and electronic formats, posting daily inpatient census information to create charges, and maintaining accurate billing setup in the EHR system. The specialist communicates directly with clients, insurance companies, and other third-party payers to clarify coverage and explain eligibility and client liability. The position also maintains current knowledge of Medicaid, Medicare, and HMO policies, procedures, and regulations; supports agency compliance; records payments received; and notifies clients or responsible parties about delinquent accounts.

Requirements

A minimum of two years of work experience in accounting, bookkeeping, or billing.
Prior to hire, complete a background check that includes criminal record history.
Knowledge of CPT codes, medical billing codes, and insurance billing processes.

Nice To Haves

Graduation from an approved two-year accounting program or equivalent experience is preferred.
Medical billing experience is preferred.

Responsibilities

Verify insurance eligibility and enter eligibility and financial information into the computer system.
Determine clients’ maximum monthly liability and monthly payment.
Verify insurance coverage for outpatient and inpatient clients.
Obtain releases, prior authorizations, and insurance information needed for inpatient billing.
Handle billing, collections, and reimbursements for Children’s Long Term Support services, Birth-3 services, outpatient and inpatient charges, and private-pay bills.
Run edit reports and verify billing reports for accuracy.
Submit and resubmit bills to primary insurance and rebill secondary and tertiary insurers using paper and electronic formats.
Post the daily inpatient census to create charges.
Communicate with clients, insurance companies, and other third-party payers to clarify coverage and explain client liability and eligibility.
Maintain current knowledge of Medicaid, Medicare, and HMO policies, procedures, and regulations and maintain agency compliance.
Receive and record payments for services and notify clients or responsible parties of delinquent accounts.
Assist with setting up programs and services in the EHR system for accurate billing.