Medical Billing Specialist jobs in Racine, WI

"It's about leadership, creativity and purpose."

Our LTAC Hospital specializes in caring for patients challenged with traumatic brain Injuries and other neurobehavioral and medically complex conditions.

Position Purpose:

Responsible for accurate and timely preparation and submission of claims for Physician Fees. Monitors Fraud and Abuse regulations, ensures that facility is compliant with all regulations pertaining to billing. Investigates and reports same to Department Head and assists in implementing educational and procedural changes as identified.

Key Responsibilities:

1 Prompt and accurate submission of claims in order to maximize reimbursement and assure sufficient cash-flow to the facility.

2 Maintains A/R aging within standards through review of remittance advices, software system files (e.g. LIMO) to identify claims either denied or not acted upon by government or other payers.

3 Assures facility compliance with Billing and Coverage regulations with special sensitivity to fraud and abuse elements of the Commercial program.

4 Acts as a resource for clients, guarantors, payers having concerns as to the billing and subsequent transactions on the accounts receivable.

5 Works diligently to rectify delinquent accounts. Sends letters and makes telephone calls for payment of delinquent accounts.

6 Assists in the management of patient medical information.

7 Follows facility policies and procedures and works to ensure for a safe environment.

Qualifications:

1. Strong understanding of government and commercial billing and reimbursement procedures is needed. Knowledge of HCFA 1500 UB04 claim forms. Experience in physician hospital billing desired. Candidate must be organized and able to multi-task. Overall knowledge of business office procedures and hospital general policies

2. Education: A high school diploma is required. One to two years of college preferred

3. Licensure: None required

4. Experience: One-year experience in a hospital, similar medical facility, or physician's office preferred. Minimum six months' experience in a hospital insurance billing or one year experience with a major carrier in the area. Through knowledge of claims submission processor all of major carriers and intermediaries.

This is a full-time non-remote position.