Medical Billing and Claims Professional

5 days ago


Wausau, Wisconsin, United States WAUSAU BONE & JOINT Full time
Job Summary: We are seeking a highly skilled Medical Billing and Claims Specialist to join our team at Wausau Bone & Joint. The successful candidate will be responsible for managing Accounts Receivable, providing excellent customer service, and maintaining a comprehensive understanding of insurance rules and regulations.

Key Responsibilities:
• Maintains comprehensive understanding of insurance rules, regulations, and payer contract requirements.
• Monitors Insurance Accounts Receivable for both our Clinic and Surgery Center by following up on unpaid or denied insurance claims while adhering to insurance carrier guidelines.
• Files, refiles, and/or appeals claims to obtain maximum reimbursement and works credit balances in a timely manner.
• Answers inquiries from insurance carriers and patients via mail or telephone.
• Processes patient payments received via mail or telephone.
• Covers phone line for incoming Insurance Team calls.
• Updates demographic information in the system.
• Cross-trains on functions within Patient Accounts to help provide coverage occasionally as requested.

Requirements:
• High school diploma or equivalent.
• One or more years' medical billing and/or insurance experience required.
• One or more years' experience balancing accounts and handling payments required.
• Ability to make sound judgments according to procedures or acceptable recommendations for exceptions when needed.
• Current knowledge of insurance reimbursement structure.

Qualifications:
• Excellent interpersonal skills to build effective partnering relationships with internal departments.
• Excellent communications skills both written and verbal.
• Ability to work on a variety of projects accurately and within timelines.
• Microsoft Excel and Word experience.
• Valid WI Driver's License.

Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to stand; walk; sit; use hands to type; and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, and bend. The employee must occasionally lift and/or move boxes up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

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