Insurance Billing Specialist-1.0 FTE

LADD MEMORIAL HOSPITAL • Osceola, WI

2d • Hybrid

About The Position

The Insurance Billing Specialist is responsible for submitting and managing insurance claims within the Epic EMR system. This role investigates and resolves claim errors and denials, processes appeals, and identifies billing trends requiring escalation. The Insurance Billing Specialist plays a key role in ensuring accurate, timely reimbursement while supporting hospital and clinic revenue cycle operations.

Requirements

• High school diploma or GED required
• Experience with hospital, clinic, or CAH/RHC billing
• Knowledge of CPT, ICD-10, HCPCS coding, and claim processing rules
• Strong organizational, problem-solving, and communication skills
• Knowledge of hospital and clinic billing processes, including Medicare, Medicaid, and commercial payer requirements
• Understanding of CPT, HCPCS, ICD-10-CM, and revenue codes, as applicable
• Familiarity with claims submission, payment posting, denials, adjustments, and appeals processes
• Strong attention to detail with the ability to maintain accuracy and meet deadlines
• Effective written and verbal communication skills
• Ability to analyze and resolve billing discrepancies and payer rejections
• Ability to manage multiple priorities in a fast-paced healthcare environment
• Ability to maintain HIPAA compliance and handle confidential information appropriately
• Ability to work independently and collaboratively within revenue cycle and clinical teams

Nice To Haves

• additional medical billing education preferred
• Proficiency in EPIC EMR system preferred
• Proficiency with electronic medical record and billing systems (Epic or comparable systems)

Responsibilities

• Submit accurate and timely insurance claims using Epic EMR
• Identify and correct billing-related errors preventing claim submission
• Investigate and resolve claim denials using billing work queues
• Perform payer follow-up as assigned to ensure timely resolution
• Process appeals in accordance with federal, state, and payer guidelines
• Document all actions taken on claims and appeals within the system
• Identify and escalate recurring issues, trends, or payer patterns to the Lead Biller or Billing Manager
• Collaborate with internal teams and departments to ensure efficient revenue cycle workflows

What This Job Offers

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