Responsible for following up directly with commercial and governmental payers to resolve billing issues and secure appropriate reimbursement in a timely manner. The role identifies and analyzes denials and payment variances, then implements corrective measures to support effective communication and resolution of payer errors.
Key duties include examining denied and underpaid claims, communicating with payers regarding outstanding claims and payment variances, identifying trends and root causes of denials, maintaining billing compliance awareness, and supporting continuous quality improvement efforts. The position also involves professional communication with internal departments and external payers, along with participation in hospital committees, performance improvement initiatives, and team projects.
High school diploma or equivalent required.
Minimum of one year of relevant experience in mental health or medical insurance billing and/or collections.
Demonstrated knowledge of:
- Third-party payer guidelines
- Reimbursement, follow-up, and collections
- Claims review and analysis
- ICD-10, CPT, and HCPCS coding
- Medical terminology
Additional qualifications:
- Effective communication, leadership, organizational, and problem-solving skills
- Ability to manage multiple tasks and projects simultaneously
- Ability to analyze data, identify improvement opportunities, and implement change
- Strong interpersonal and customer service skills
- Proficiency with Microsoft Word, Excel, Outlook, Teams, OneNote, and Oracle Health Patient Accounting systems
- Ability to work quickly and effectively in a fast-paced, detail-oriented environment while meeting deadlines
Health, dental, and vision insurance coverage for employee and family
401(k) retirement plan
Employee share program
Life and disability insurance
Flexible spending accounts
Tuition reimbursement
Health and wellness program
Employee assistance program (EAP)
Location
Wisconsin, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago