Claims Submission Representative

Children's Hospital and Health System • West Allis, WI

1d

About The Position

At Children’s Wisconsin, we believe kids deserve the best. Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country. We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today. Please follow this link for a closer look at what it’s like to work at Children’s Wisconsin: https://www.instagram.com/lifeatcw/ Job Summary Responsibility for the submission of all paper and electronic claims. This will include primary, secondary, and specialty claims. Will have assigned work-queues to correct billing, charging, and registration edits.

Requirements

• High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required
• 2+ years experience of billing and/or claims follow up , HCFAs and/or UB-04’s (preferably in a hospital setting) including insurance reimbursement procedures and comprehension of insurance EOB’s required
• Working knowledge of medical terminology, ICD-9, CPT and HCPCS level II codes.
• Excellent verbal and written communication skills.
• Strong analytical skills and ability to perform non‑complex arithmetic calculations when determining contractual allowances.
• Ability to work independently with minimal supervision.
• Proficient in Microsoft Office applications and technology skills required to perform duties.
• The ability to multi-task and function effectively in a team environment and maintain successful relationships with coworkers, patients, physicians, management, staff, and other customers.

Nice To Haves

• General pediatric and/or pediatric subspecialty experience preferred
• Prior EPIC, QSI or IDX experience is strongly preferred
• Bilingual skills a plus.

Responsibilities

• Facilitates the daily submission of electronic claims to the clearinghouse.
• Along with the Lead, participates in the claims reconciliation process.
• Works assigned work-queues to correct billing, charging, and registration edits.
• Calculates and applies appropriate contractual discounts at the time of billing.
• Utilizes payer websites and electronic eligibility clearinghouses to verify the accuracy of patient insurance information.
• Utilizes payer websites for direct claim entry when necessary.
• Submits secondary claims to payers according to department policy and procedure and payer guidelines and requirements.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees