Billing and Claims Specialist

3 weeks ago

Milwaukee, United States Healing Harmonies, LLC Full time

The billing & claims specialist is a part time position and will handle accounts receivables, audit and track authorizations, maintain and run frequent accounting, cash flow and financial reports. This position will also prepare and submit claims and invoices to various types of payer sources such as WI Medicaid, schools,hospice agencies as well as private pay clients. Ongoing client follow up regarding past due accounts as well as status of authorizations for services is a large part of this position and so patience, resourcefulness and strong communication and customer service skills are a must.

This position will collaborate heavily with the operations manager and also requires frequent meetings with the leadership team to ensure timely payments for services and management of past-due accounts.

Responsibilities include:

- Responsible for posting all payments, invoicing, purchases as well as updates to client and vendor accounts within billing software to ensure accurate financial reporting for all bookkeeping receipts and transactions.
- Match transactions and invoices paid on approved accounts payable within billing software reconciliation.
- Prepare and submit invoices via billing software to private payers and other organizations in a timely manner.
- Collect and review Medicaid referrals and authorizations for accurate data and to facilitate ease of collections.
- Receive, record and categorize payments in billing software.
- Match transactions and invoices paid on approved accounts payable within billing software.
- Facilitate weekly bank deposits.
- Follow up on late payments and resolve financial discrepancies.
- Confirm client accounts and coverage eligibility.
- Investigate, track and appeal denied claims in a timely manner.
- Facilitate third party payee claims and billing to ensure accurate fee structures, submit claims for payment and include required documentation ensuring timely payment and current cash flow.
- Consistent follow up with relevant program service coordinators to ensure authorization and progress of payments for Medicaid covered client work.
- Follow up with service coordinators upon denial of payment to ensure timely progress of incomplete authorizations and/or payments for Medicaid Waiver client work.
- Audit authorizations to watch for newly canceled or upcoming expiration of authorizations.
- Effectively communicate authorization status of Medicaid covered clients with the office coordinator.
- Facilitate the collection of past due accounts including creation and distribution of aging and bad debt reports for OM.
- Track and collect on any payment plans for accounts in arrears with authorization from the CEO for qualifying families and clients.
- Prepare accounting, cash flow and financial reports for monthly review.
- Attend, monthly accounting meeting with OM, CEO and Office Coordinator in a prepared and timely manner.
- Update and document client communications regarding billing questions and payments to resolve or escalate to the Operations Manager as appropriate.
- Deliver bank statements, accounting receipts and any relevant information to CPA to assist in account reconciliation.
- Follow and adhere to all regulations and guidelines set forth by federal and state programs

Requirements for success include:

- 2+ years of billing experience (Accounts receivable, invoicing, claims management, medical billing) preferred
- Proficiency with Microsoft Suite
- Superior level of attention to detail with a commitment to accuracy.
- High level of organization and time management skills
- Ability to work independently as well as within a team environment
- Outstanding customer service/interpersonal skills
- Trustworthy, dependable, and operates with integrity

Prefer, though not required:

- Knowledge of and experience in working with WI Medicaid programs
- Associates Degree or BA in a related field

**Job Types**: Full-time, Part-time

Pay: $17.00 - $21.00 per hour

Expected hours: 25 - 30 per week

**Benefits**:

- 401(k)
- 401(k) 3% Match
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Retirement plan
- Vision insurance

Schedule:

- Monday to Friday

Work setting:

- Hybrid work
- Office

**Education**:

- Associate (preferred)

**Experience**:

- Medical billing: 2 years (preferred)
- Customer service: 1 year (preferred)

Ability to Relocate:

- Milwaukee, WI 53222: Relocate before starting work (preferred)

Work Location: Hybrid remote in Milwaukee, WI 53222

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