Insurance Billing Specialist

St Croix Health•St. Croix Falls, WI

just now•Hybrid

About The Position

St. Croix Health is looking for a full-time (1.0 FTE) Insurance Billing Specialist to join our team. This position will work Monday through Friday, day hours. This position will work 100% onsite at our St. Croix Falls, WI location during the training period (approximately first 1 - 3 months of employment). Once training is complete, possibility to move to hybrid. Hybrid employees are required to live within a commutable distance from our primary location in St. Croix Falls as on-site workdays, meetings and trainings are required. The Insurance Billing Specialist is responsible for billing medical claims to insurance and ensuring maximum payment and reimbursement of claims. This position resolves clinic and hospital related claim holds, denials and incorrect billing information. They monitor claim status, filing limits, and policies for Medicare, Medicaid and Commercial plan billing practices. This Insurance Billing Specialist is responsible for all billing for St. Croix Regional Medical Center claims to include Rural Health and Critical Access.

Requirements

High school graduate required
Associates degree in Medical Administration or related field preferred
Healthcare experience required without secondary degree
Minimum 1-2 years of billing or charge entry experience in healthcare is preferred
Experience with electronic medical records and billing systems
Experience in a healthcare business office
Intermediate/Advanced computer skills, including but not limited to Microsoft Office products
Excellent interpersonal, verbal, and written communication skills
Understanding of Critical Access and Rural Health billing
Ability to deal effectively and assertively with a broad range of people under varying pressure situations
Adaptability to constantly changing processes, software systems, and payer programs
Medical billing background to include knowledge of ANSI codes, CPT, and HCPCS codes, insurance terminology
Knowledge of insurance billing both UB92/8371 and HCFA 1500/837P claims processing
High level interpretation and understanding of payer remittance advices in both paper and electronic formats
Exceptional knowledge of Medicare, Medicaid, HMO, and private payer billing rules and regulations
Self-motivated, takes ownership in expectations/goals, and sees them through in a timely manner, and seeks supervision appropriately
Prolonged periods of sitting at a desk and working on a computer.
Must be able to lift up to 15 pounds at times.

Responsibilities

Process insurance claims
Follow-up on claim denials and follow-up on all unpaid and/or underpaid encounters
Identify trends and work towards resolution
Assists patients with billing questions and concerns