BILLING SPECIALIST

ORTHOPAEDIC ASSOCIATES OF WISCONSIN • Village of Pewaukee, WI

just now • Hybrid

About The Position

The Medical Billing Specialist is responsible for managing the billing and reimbursement process at OAW. This role involves preparing and submitting claims to insurance companies, following up on unpaid claims, and ensuring accurate billing records. This role requires meticulous attention to detail, strong organizational skills, and a thorough understanding of medical billing procedures, codes, and regulations. The specialist will work closely with the medical staff, patients, and insurance companies to provide timely and accurate payment for services rendered.

Requirements

• High School Diploma or equivalent
• Three or more years required experience in specialty insurance collections in a medical facility/practice or for a revenue cycle management company
• Minimum of two years of experience in accounts receivable is required
• Basic understanding of medical terminology, CPT4, and ICD-10 coding. Revenue management systems experience.
• Must be able always to maintain a professional attitude and confidentiality.
• Strong oral and written communication, and time management skills
• Ability to work in a team environment and confident interpersonal skills
• Familiarity with HMO, Medicare, Medicaid, commercial insurance guidelines, and medical terminology
• Ability to multitask in a high volume, fast paced working environment.

Nice To Haves

• Experience using EPIC and Microsoft Office preferred.

Responsibilities

• Monitor and follow up on unpaid claims, ensuring timely reimbursement.
• Resolve billing and insurance discrepancies, rejections, and denials.
• Follow up on billing AR on no responses from payers.
• Communicate professionally with patient inquiries regarding billing and insurance questions. Provide clear explanations of charges, insurance benefits, and payment options. Assist patients in setting up payment plans if necessary.
• Stay updated with current billing regulations, insurance guidelines, and compliance requirements. Prepare and maintain accurate billing records and reports.
• Work closely with coding team, authorization team and other departments to ensure accurate coding and authorizations.
• Communicate effectively with insurance companies to resolve issues and clarify billing information.
• Always maintain strict client and patient confidentiality.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED