Senior Billing Specialist
Milwaukee, WI US
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Posted 26 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, post insurance and patients’ payments within Centricity practice management system. Manage all ticket statues within Centricity.  Maintain a designated level of collections by means of payments and complete follow up for all denied claims through to payment status. Follow up and collect all outstanding receivables from payers, patients and provide excellent customer service to both internal and external customers.
 
Positon-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 follow up issues related to their standard process.
  • Functional expert who handles escalated issues and provides guidance on complex/unusual transactions.
  • Review, revise, re-process and follow-up on all denials.
  • Documenting of accounts
  • Process appeals in a timely manner according the payer contract.
  • Process all patients and insurance refunds.
  • May identify and lead process changes as a result of financial, process and data integrity audits.
  • Run reports within Centricity.
  • Lead special projects as necessary.
  • Assist supervisor when needed.
Required Knowledge, Skills and Abilities:
 
  • Must have 5+ years of experience working in physician or hospital collection setting; knowledge of ICD-10, CPT Codes and HCPC Codes
  • Excellent working 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
  • Maintains relationships with insurance companies
  • 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

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Hours per Week
40 hours
Work Hours (i.e. shift)
8am-4:30pm
Required Education
Associate Degree
Required Experience
5 to 10 years
 This company is a Federal Contractor
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