Medical Billing Specialist

Unity Hospice•Green Bay, WI

6d•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 discrepancies, and coordinating payment arrangements when appropriate. The position requires a strong understanding of Medicare billing requirements and a commitment to providing outstanding service to patients, insurance providers, and internal partners. This is a part-time, fully remote position for Wisconsin residents, working 20 hours per week. The schedule is Monday through Friday, four hours per day, with a consistent daily shift scheduled between 7:00 a.m. and 5:00 p.m.

Requirements

Associate degree, relevant work experience, or an equivalent combination of education and experience.
At least 2 years of medical billing experience.
Part A and Part B Medicare billing experience.
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.
Initiative, self-motivation, and a professional work ethic.
Must reside in Wisconsin.

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 billing process, including working assigned billing queues and ensuring 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 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.