Billing Specialist
Milwaukee, WI US
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Posted 24 days ago
Job Description
Milwaukee Health Services, Inc. (MHSI) is a Federally Qualified Community Health Center (FQHC) that operates from two (2) sites: The Isaac Coggs Heritage Health Connection at 8200 W. Silver Spring Drive and the MLK Heritage Health Center at 2555 N. Martin Luther King Drive. MHSI offers a range of primary health care services including Medical, Dental, Behavioral, Women’s Health, Benefit Determination, and Pharmacy. FQHCs service everyone regardless of income, or third party coverage, and seek to provide high quality care in accessible locations and at convenient times. Our particular sites primarily target the residents of Milwaukee’s north side, but service patients countywide. FQHCs are unique in their delivery of care, patient population and provision of services. FQHCs seek to provide quality care in an underserved area to the uninsured or underinsured populations that would otherwise not have access to care.

Please visit the MHSI website at
www.mhsi.org to understand the dynamics of FQHCs

Position Summary:
  Responsible for retrieving all billable charges within Centricity Practice Management System. Manage all ticket statues within Centricity. Maintain a designated level of collections by means of payments and complete follow through for all denied or rejected claims. Follow up and collect all outstanding receivables from payers, patients and provide excellent customer service to both internal and external customers.
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Position-Specific Competencies/Essential Functions/Duties& Responsibilities
 
  • Retrieve all billable Centricity charges within 48hrs.
  • Review, resolved and bill all outstanding statuses within a timely manner.
  • Direct contact with customers to research and resolve all inquiries on their account.
  • Monitoring customer account activity through queries and statement review.
  • Monitor and maintain the 120 Day AR Aging Report at 15% or < to ensure the department’s best practice.
  • Ability to independently resolve most of the follow up issues related to their standard process.
  • Review, revise, re-process and follow-up on all denials and system rejected claims.
  • Documenting of accounts
  • Process appeals in a timely manner according the payer contract.
  • Process all patients and insurance refunds.
  • Ability to run reports with Centricity
  • Participates in educational activities and attends staff meetings
  • Maintains strictest confidentiality; adheres to all HIPAA and PHI guidelines/regulations.
Required Knowledge, Skills and Abilities:
 
  • Must have 3+ years of experience working in physician or hospital collection setting; knowledge of ICD-10, CPT Codes and HCPC Codes
  • Knowledge of insurance carriers’ payment regulations including various reimbursement schemes, co-insurance, and deductibles, and contractual adjustments
  • Knowledge of Medicare, Medicaid, managed care, commercial insurance, worker’s compensation and sliding fee
  • Working knowledge of HIPAA and PHI regulations and compliance
  • Work with payers to determine reasons for denials, corrects and reprocesses claims for payment in a timely manner
  • Reduces claims in the over 90-day categories
  • Mails, faxes or emails all appropriate collections correspondence
  • Identifies uncollectible accounts and acquires approval for Bad-Debt Write/Off
  • Strong interpersonal and communications skills to be able to work successfully in team-oriented environment
  • Technical aptitude
  • High attention to detail and the ability to multi-task
  • Possess a working knowledge of Centricity PMS/EMR, Microsoft Outlook, Word and Excel
  • Experience collecting on health plan claims
  • Hours may vary based on organizational need
  • Travel may vary based on organizational need
Qualifications:
 
  • Minimum Education Level:  High School Diploma
  • Minimum 3 years of experience on the job training in a FQHC or clinic, physician’s office or hospital setting.

Milwaukee Health Services, Inc. is an equal opportunity employer.

Milwaukee Health Services, Inc. does not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or veteran status.

 

Job Summary
Start Date
Immediate
Employment Term and Type
Regular, Full Time
Hours per Week
40
Work Hours (i.e. shift)
8am to 5pm
Required Education
Certification or Vocational
Required Experience
1+ years
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