Senior Billing Specialist

Illuminus•Watertown, WI

About The Position

Illuminus is seeking a highly motivated individual with excellent collaboration and organizational skills to join our team as a Senior Billing Specialist In this role, you will responsible for overseeing the complete billing cycle including Medicare, Medicaid, and third-party insurance claims. Candidates must have experience with nursing home/SNF billing. Summary Maintains and actively promotes effective communication with all individuals. Maintains a positive image of the entity in the community keeping in alignment with our mission, vision, and values. Ensures timely and accurate billing. Monitors, analyzes and resolves claim discrepancies. Performs follow-ups and appeals as necessary. Develops strategies to improve clean claim rate. Coordinates with admissions, medical records and clinical teams to ensure accurate documentation and authorization. Serves as a point of contact for escalated billing inquiries and complex issues. Assists in internal audits to ensure compliance with billing policies. Mentors Billing Specialists to maintain quality and efficiency in billing processes. Leads Aging calls and keeps Finance department management appraised of expected payment issues. Remains current on changes to payer rules and attends billing seminars as necessary. Works with other departments and functions on following Accounts Receivable procedures and maintaining adequate controls which includes training new hires or groups of employees that may join the organization outside of the function. Responsible for on-call and performs other duties, as assigned.

Requirements

Two-year associate degree.
Experience with nursing home billing.
Four to five years accounts receivable experience.
Must have experience in nursing home billing.
Additionally, at least two years in medical billing, medical insurance verification, managed care and/or patient registration.
Knowledge of health insurance plans including Medicare, Medicaid and Commercial carriers.
Word processing and spreadsheet knowledge.
Commitment to quality outcomes and services for all individuals.
Excellent communications and human relation skills.
Ability to relate well to all individuals.
Ability to maintain and protect the confidentiality of information.
Ability to exercise independent judgment and make sound decisions.
Ability to be flexible with daily routines and tolerant of interruptions.
Utilize creativity and initiative to continuously improve processes and procedures through the use of technology and process improvement techniques and adapt to change.

Nice To Haves

Previous experience with Point Click Care and medical terminology a plus.

Responsibilities

Overseeing the complete billing cycle including Medicare, Medicaid, and third-party insurance claims.
Maintains and actively promotes effective communication with all individuals.
Maintains a positive image of the entity in the community keeping in alignment with our mission, vision, and values.
Ensures timely and accurate billing.
Monitors, analyzes and resolves claim discrepancies.
Performs follow-ups and appeals as necessary.
Develops strategies to improve clean claim rate.
Coordinates with admissions, medical records and clinical teams to ensure accurate documentation and authorization.
Serves as a point of contact for escalated billing inquiries and complex issues.
Assists in internal audits to ensure compliance with billing policies.
Mentors Billing Specialists to maintain quality and efficiency in billing processes.
Leads Aging calls and keeps Finance department management appraised of expected payment issues.
Remains current on changes to payer rules and attends billing seminars as necessary.
Works with other departments and functions on following Accounts Receivable procedures and maintaining adequate controls which includes training new hires or groups of employees that may join the organization outside of the function.
Responsible for on-call and performs other duties, as assigned.

Benefits

Employee Referral Bonus Program.
Educational Advancement/Training Opportunities (Wound care, IV administration etc., provided by our Illuminus Institute or Other External Qualifying Educational institution)
Paid Time Off and Holidays acquired from day one of hire.
Health (low to no cost), Dental, & Vision Insurance
Flexible Spending Account (Medical and Dependent Care)
401(k) with Company Match
Financial and Retirement Planning at No Charge
Basic Life Insurance & AD&D - Company Paid
Short Term Disability - Company Paid
Voluntary Ancillary Coverage
Employee Assistance Program
Benefits vary by full-time, part-time, and PRN status.