Insurance Claims Specialist

2 days ago


Milwaukee, Wisconsin, United States Sixteenth Street Community Health Center Full time
Job Summary

We are seeking a highly skilled and detail-oriented Insurance Claims Specialist to join our team at Sixteenth Street Community Health Center. As a key member of our revenue cycle team, you will be responsible for ensuring timely and accurate communication with internal teams and external customers, as well as exercising revenue cycle knowledge to resolve insurance claims efficiently.

Key Responsibilities
  • Obtain necessary documentation from various resources to support insurance claims
  • Communicate effectively with internal teams and external customers to resolve claims-related issues
  • Identify and report patterns and trends to leadership regarding coding and compliance, contracting, claim form edits/errors, and credentialing
  • Stay up-to-date with insurance payer updates/changes and single case agreements
  • Accurately enter and/or update patient/insurance information into the patient accounting system
  • Appeal claims to ensure contracted amounts are received from third-party payors
  • Comply with KPI standards established by department and insurance guidelines
  • Compile information for referral of accounts to internal/external partners as needed
  • Maintain clear, accurate, online documentation of all activity relating to billing and follow-up efforts
Requirements
  • High School Diploma or General Education Degree (GED)
  • Typically requires 1 year of related experience in a medical/billing reimbursement environment or an equivalent combination of education and experience
  • Experience in EPIC preferred
  • Basic keyboarding proficiency and ability to operate computer and software systems
  • Ability to read, write, speak, and understand English proficiently
Preferred Qualifications
  • Knowledge of medical terminology, coding, and insurance/reimbursement practices

We offer a dynamic and supportive work environment, and we are committed to providing our employees with the training and resources they need to succeed. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional patient care, we encourage you to apply for this exciting opportunity.



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