St. Croix Health ยท 1 month ago
Insurance Billing Specialist
St. Croix Falls,WI,US
Full-time
Hybrid
Entry Level
1+ years expSt. Croix Health is a not-for-profit healthcare system dedicated to helping people live healthier, happier, and longer lives. The Insurance Billing Specialist will be responsible for billing medical claims to insurance, ensuring maximum payment and reimbursement, and resolving any issues related to claims.
Health CareMedical
Responsibilities
Process insurance claims
Ensure appropriate processing of claims
Verify patient eligibility or coverage as needed for all payors
Knowledge of UB and 1500 claim elements impacting processing
Accountable for accurate and timely claim submissions in accordance with A/R goals
Follow-up on all unpaid claims and/or underpaid encounters
Works billing queues timely
Accountable for account aging and incoming correspondence timely and appropriate follow-up
Follow-up on denials
Analyze, research, and navigate payer specific coverage and reimbursement policies
Accountable to analyze reason for denial and to work towards appropriate resolution
Knowledge of appeal process by payer
Assists patients with billing questions and concerns
Knowledge of all insurance explanation of benefits
Ability to work with insurance provider and member services to ensure patient understanding and claim processing
Qualification
Required
High school graduate
If no degree, healthcare experience required
Basic computer skills, including but not limited to Microsoft Office products
Ability to assess and prioritize workload
Excellent interpersonal, verbal, and written communication skills
Adaptability to change
Self-motivated, takes ownership in expectations/goals, and sees them through in a timely manner, and seeks supervision appropriately
Knowledge of insurance billing both UB04/837 I and HCFA 1500/837P claims processing & insurance terminology
Understanding of Critical Access and Rural Health billing
Knowledge of Medicare, Medicaid, HMO, and private payer billing rules and regulations
Ability to interpret and understand of payer remittance advices
Prolonged periods of sitting at a desk and working on a computer
Must be able to lift up to 15 pounds at times
Preferred
Associates degree in Medical Administration or related field
1-2 years of billing or charge entry experience in healthcare
Experience with electronic medical records and billing systems
Experience in a healthcare business office
Benefits
Health, vision and dental insurance
403b retirement program with employer match
Paid time off
Short-term disability, long-term disability and life insurance options
Education reimbursement
Employee assistance program (EAP)
Wellbeing incentive program
Free parking
Employee prescription discount program
Company
St. Croix Health
St. Croix Health has been a healing force in the St. Croix Valley since 1919. Our traditions hold true today.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Kimberly Ericson
Chief Financial Officer
Andrea Jerrick, MBA
Chief Administrative Officer
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