Specialized Billing Clerk
About The Position
Claim Submission: Prepare, review, and submit claims for services provided to adults with I/DD, ensuring accuracy and completeness. Denial Management and Appeals: Monitor unpaid and denied claims, research the reasons for denial, make necessary corrections, and file appeals with payers as appropriate to ensure timely reimbursement. Accounts Receivable Management: Manage and follow up on accounts receivable aging, post payments, debits, and credits accurately, and work with Program Managers regarding co-pays or outstanding balances. Compliance and Reporting: Maintain up-to-date knowledge of all Medicaid regulations and billing guidelines (including HIPAA), assist in audits, and prepare reports for management on billing activities and financial performance. Collaboration and Communication: Serve as a liaison, communicating effectively with internal staff and external parties to resolve issues and ensure smooth processes. Specialized Knowledge: Understand alternative integrated models and specific service delivery methods relevant to individuals with I/DD to ensure proper billing and maximize eligible reimbursements. Wisconsin Family Care Position is 18-25 hours a week - This position requires employee to be on premises. No remote type of work
Requirements
- Previous experience (typically 1-2 years minimum) in specialized billing, claims processing, and accounts receivable follow-up is required.
- Strong knowledge of Medicaid, and funding source agencies strongly encouraged
- Competence in using billing software, and Microsoft Office Suite (especially Excel).
- Excellent attention to detail, strong analytical and problem-solving skills, good organizational and time management abilities, and effective communication skills are essential for success in this role.
Nice To Haves
- Experience working within a nonprofit or with individuals with I/DD is often preferred.
Responsibilities
- Prepare, review, and submit claims for services provided to adults with I/DD, ensuring accuracy and completeness.
- Monitor unpaid and denied claims, research the reasons for denial, make necessary corrections, and file appeals with payers as appropriate to ensure timely reimbursement.
- Manage and follow up on accounts receivable aging, post payments, debits, and credits accurately, and work with Program Managers regarding co-pays or outstanding balances.
- Maintain up-to-date knowledge of all Medicaid regulations and billing guidelines (including HIPAA), assist in audits, and prepare reports for management on billing activities and financial performance.
- Serve as a liaison, communicating effectively with internal staff and external parties to resolve issues and ensure smooth processes.
- Understand alternative integrated models and specific service delivery methods relevant to individuals with I/DD to ensure proper billing and maximize eligible reimbursements.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Part-time
Career Level
Entry Level
Education Level
No Education Listed
