Medical Billing Specialist

Unity Hospice•Green Bay, WI

7d•Remote

About The Position

The Medical Billing Specialist calculates, processes, and collects payments for medical procedures and services. The role performs complex billing, clerical, and accounting functions, including maintaining patient and third-party billing records, verifying and processing claims, following up on outstanding balances, resolving billing discrepancies, and coordinating payment arrangements when appropriate. The position prepares and submits billing for Supportive Care Management, clinician visits, and hospice services; completes claim processing and related authorization and notice workflows; reviews explanations of benefits; and works with patients, insurers, facilities, and other parties to resolve account issues and support timely reimbursement. The specialist also maintains accurate records and aging reports, assists with procedure documentation and reporting, and provides support to management as requested. This is a part-time, fully remote position for Wisconsin residents, scheduled for 20 hours per week: four hours per day, Monday through Friday. The consistent daily shift is scheduled within 7:00 a.m.–5:00 p.m.

Requirements

Associate degree, relevant work experience, or an equivalent combination of education and experience.
Minimum of 2 years of medical billing experience.
Part A and Part B Medicare billing experience required.
3–5 years of customer service experience.
Experience with CMS rules and regulations for both professional and facility settings.
Knowledge of Medicare, Medicaid, and commercial insurance billing requirements.
Understanding of CMS billing guidelines and reimbursement requirements.
Experience with Electronic Medical Record (EMR) systems.
Proficiency with Microsoft Office, particularly Excel and Word.
Strong problem-solving, analytical, and organizational skills.
Excellent verbal and written communication, phone, and customer service skills.
Ability to work independently while contributing to a collaborative team environment.
Ability to manage multiple priorities, work through frequent interruptions, and meet deadlines in a fast-paced environment.
Strong attention to detail and commitment to accurate documentation.
Ability to build effective relationships and collaborate with internal and external customers.
Demonstrates initiative, self-motivation, and a professional work ethic.

Nice To Haves

Epic experience.

Responsibilities

Prepare and submit patient and insurance billing for Supportive Care Management, clinician visits (including physicians and APNs), and hospice services.
Complete the full billing process, work assigned billing queues, and ensure timely claim submission.
Submit prior authorizations as needed.
Enter Medicare and Medicaid Notices of Election and provide backup support for terminations and revocations.
Complete Skilled Nursing Facility hospice pass-through billing.
Review and post Explanations of Benefits (EOBs) for accuracy.
Follow up on submitted claims, unpaid balances, and outstanding patient accounts; resubmit claims and correct inaccuracies as needed.
Maintain accurate aging reports and investigate outstanding balances in a timely manner.
Research and resolve billing discrepancies, payment variances, disputes, reversals, and appeals.
Coordinate with insurance carriers, patients, facilities, and other parties to resolve account issues and support timely reimbursement.
Provide telephone support regarding claim status, claim adjudication, and basic coverage questions.
Review secondary and tertiary payer information to support claim payment, resubmissions, and account adjustments.
Identify and communicate contractual allowance concerns, reimbursement discrepancies, and unresolved accounts to appropriate billing leadership.
Maintain accurate patient and billing records in accordance with Unity's policies and procedures.
Assist with procedure development, forms, manuals, and reporting as needed.
Provide data and other support to management as requested.
Perform other duties as assigned.

Benefits

Medical, dental, and vision insurance.
Health Savings Accounts and flexible spending options for medical and dependent care.
On-site health risk assessments and flu shots.
Paid time off.
Extended illness and injury bank.
Bereavement leave.
Employee Assistance Program.
Fitness membership reimbursement.
403(b) retirement savings plan.
Group life insurance and voluntary life insurance.
Accident, critical illness, and disability insurance options.
Competitive pay.
Overtime opportunities for hourly roles.
Mileage reimbursement.
Internal and external learning opportunities.
Education assistance.
Leadership development programs.