Medical Billing Specialist

BLACK RIVER HEALTH INCBlack River Falls, WI
9dOnsite

About The Position

Black River Health is seeking a detail-oriented, motivated professional to join our Finance & Revenue Cycle team as a Medical Billing Specialist. In this role, you will ensure accurate billing, timely claim submission, effective follow-up, and strong collaboration across departments to support the financial health of our organization. As a Medical Billing Specialist, you will play a key role in ensuring claims are processed accurately and efficiently while supporting both patients and internal teams. Your responsibilities include:

Requirements

  • A solid understanding of medical and billing terminology
  • Experience managing denied claims and performing denial management
  • Familiarity with UB‑04 and CMS-1500 claim forms
  • Experience interacting with representatives from various health plans
  • Ability to interpret Explanation of Benefits (EOBs) to assess proper reimbursement
  • Knowledge of billing codes
  • High School Diploma or GED required
  • Minimum of 2 years of billing experience required; 1 year of medical billing preferred
  • Proficient computer, keyboard, and calculator skills
  • Excellent oral and written communication skills

Responsibilities

  • Correct, complete, and process claims for all payors according to established standards
  • Perform follow‑up with payors on unpaid accounts identified through aging reports, denials, or payer rejections
  • Demonstrate thorough knowledge of billing policies and procedures, including editing, denial management, and appeal processing
  • Process appeals online or via paper submission, acting as a liaison between healthcare providers and insurance companies to complete appeals, reconsiderations, and corrected claims in a timely manner according to payer contracts
  • Collaborate with internal departments to ensure proper billing of claims, reduce denials, and support billing audits as needed
  • Answer and respond to correspondence, calls, and concerns related to patient accounts
  • Remain current with all regulatory requirements related to billing and adhere to HIPAA regulations and patient confidentiality
  • Accurately review payor contracts to ensure appropriate reimbursement
  • Review and initiate refund requests as appropriate
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