Payment Recovery Specialist jobs in Green Bay, WI

The Payment Specialist position manages and executes all aspects of Third Party Payer billing and financial tracking.  

Essential Functions:

1. Works with CFO, Accountant and Manager of Billing & Patient Financial Services to facilitate accurate accounting records.
2. Follows all insurance regulations.
3. Performs daily posting of payments to patient accounts.
4. Assigns appropriate denial codes to patient accounts based on Third Party Payer responses.
5. Prepares and submits refund requests when overpayments are made by Third Party Payers.
6. Prepares and submits clean secondary claims to Third Party Payers
7. Moves unpaid balances to client responsibility when appropriate.
8. Reviews outstanding credit balances and determines appropriate next steps for resolution.
9. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
10. Excellent oral, written and interpersonal communications skills.
11. Consistent and regular attendance is a requirement of the position.

Non-Essential Functions/Other Duties:

1. Performs any other tasks assigned by management

Supervisory Responsibility:  Not applicable.

Travel Required:  Minimal.  

Physical Demands:

This is largely a sedentary role, with frequent sitting and computer keyboarding (10-key) required.  Some lifting (up to 35 pounds), stooping and bending are required. 

Qualifications:

Education:

• High school diploma or equivalent.
• Coursework and/or experience in medical and/or health insurance billing, medical records management.

Experience:

• At least two years of previous medical insurance, billing, or claims processing related experience.
• Experience and strong knowledge of insurance procedures, reimbursement, contracts and insurance appeal are preferred. CPT and ICD-10 certification a plus.

Skills and Competencies:

• Strong keyboarding and computer skills to include MS Office (Word and Excel) experience at an intermediate level.  10-key data entry proficiency.
• Knowledge of basic medical coding and third-party operating procedures and practices, as well as knowledge of financial concepts.
• Experience working with basic office machinery and equipment, including computers, copiers, fax machines, multi-line phone systems, etc.
• Knowledge of HIPPA privacy and security rules and regulations.
• Excellent interpersonal skills, with the ability to communicate effectively with others.
• Strong organizational skills, with the ability to multi-task and meet deadlines.
• Demonstrates initiative, with the ability to manage self and workload.
• Strong analytical and problem solving abilities.  Good mathematical aptitude.
• Exemplary customer service focus, for both internal and external clients.
• Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere.  
• Displays professionalism and represents organization in a professional manner.
• Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines.

Other:    

• Must be 18 years old or older.