Insurance Billing Specialist

Crossing Rivers Health•Prairie du Chien, WI

5h•Onsite

About The Position

The Insurance Billing Specialist accurately and promptly reviews and updates claims needing manual intervention prior to claim submission, submits claims to insurance carriers, follows up on the status of unpaid claims, works denied claims to resolve any errors or provides necessary information to payers needed for disputing or resubmitting. This position requires routine problem solving and handles inquiries from both insurance carriers and patients, with a goal of account resolution.

Requirements

High School Graduate or General Education Degree (GED): Required
1-2 years of healthcare billing experience preferred
1-2 years of EPIC experience preferred
Microsoft Office proficiency

Nice To Haves

Associate’s Degree (two year college or technical school) Preferred, Field of Study: Business Related

Responsibilities

Reviews, edits, and corrects claims, as necessary, checking for accuracy and readiness of claims to be submitted through the electronic health record (EPIC).
Prepares and submits claims to insurance carriers and intermediaries, i.e. releasing electronic claims, printing paper claims, and/or secondary claim as required per individual payer.
Works with various departments to ensure that held claims will be released to the payer within timely filing limits.
Performs follow-up procedures, inquiring on the status of unpaid claims via phone call or various payer portals, to ensure timely payment of insurance claims.
Responds to routine patient and insurance company inquiries and problems.
Researches denials/non-covered charges and re-submits or appeals, as necessary.
Reviews late charges for re-billing or adjustment of claims, as necessary.
Reviews insurance eligibility or coverage changes to ensure accuracy of information, resolve any outstanding issues, and rebill claims when necessary.
Updates necessary changes to patient demographics and/or insurance information.
Reviews accounts with insurance credit balances and determines if a refund or other action is necessary to settle account.
Accommodates patient requests and inquiries promptly and courteously, answering incoming calls to the Business Office, educating patients on their financial responsibilities to the organization, accepting payment, setting up payment plans, etc.
Performs other duties as deemed necessary for the continued viability and success of the department and organization as a whole.
Other job duties and responsibilities as assigned to effectively meet the needs of the patients, the department, and the organization as a whole.