Billing Specialist I

Winona Health • Winona, MN

244d • Onsite

About The Position

As the Billing Specialist, you will be responsible for correcting claim errors and completing the claim submission process for all payers. Your duties will include, but are not limited to: validating registrations, obtaining accurate insurance information to coordinate benefits, performing data entry, clear validation edits, and providing process improvement suggestions for issues identified in the claims submission process. You will also analyze, research, and release insurance claims to be submitted to insurance carriers in a timely and accurate manner using the patient accounting system.

Requirements

• High school diploma or equivalent.
• Basic computer skills: Microsoft Word, Excel, Outlook, Teams, etc.
• Ability to read and interpret documents such as regulatory and standard work manuals.
• Ability to create and maintain routine reports and correspondence.
• Math skills, including the ability to compute rates, ratios, and percentages.
• Must possess effective, customer-service-oriented communication skills.

Nice To Haves

• Previous billing experience is preferred but not required.

Responsibilities

• Gathers and/or verifies patient information to validate insurance coverage and confirms patient eligibility for dates of service.
• Reviews daily registration report, claim validation reports, and encounter holds to ensure early turnaround of accounts receivable.
• Reviews errored claims for eligibility in the clearinghouse to ensure early turnaround of accounts receivable.
• Deletes claims in the clearinghouse and cancels claims in the patient accounting system to regenerate claims in the patient accounting system.
• Applies same-day holds for patients who have multiple visits to the facility on the same day.
• Posts manual charges, processes anesthesia procedure entries, and releases respiratory and cardiac charges.
• Reviews discharged not-final-billed work queue to release holds as directed.
• Processes printed paper claim forms from the clearinghouse and mails them with appropriate documentation in a timely manner.
• Completes validation edits for missing insurance numbers by either verifying eligibility or sending appropriate letters to patients when information is needed for submitting claims to the appropriate insurance carrier.
• Performs tasks to support the department, including processing and routing all incoming and outgoing mail.
• Other job duties as assigned.

Benefits

• Health Insurance: Options for medical, dental, and vision coverage, as well as mental health support and wellness incentives.
• Income Protection: Short and long-term disability, plus additional benefits like accident, critical illness, hospital indemnity, legal assistance, and identity protection plans.
• Retirement Planning: Access to a 403(b) retirement plan with employer contributions once eligibility requirements are met.
• Work/Life Balance: Flexible scheduling, paid time off, and earned sick time to support personal well-being.
• Education & Development: Paid training, tuition reimbursement, scholarships, and sponsored seminars to foster both personal and professional growth.
• Employee Discounts: Special offers with local businesses, including the YMCA and cell phone providers.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Nursing and Residential Care Facilities
• Education Level: High school or GED