What are the responsibilities and job description for the Billing Specialist position at Milwaukee Health Services, Inc?
The Billing Specialist role requires critical thinking and attention to detail. This position is responsible for timely submission/follow-up on claims for all payer types and multiple specialties. The Billing Specialist's role focuses on maximizing revenue and cash flow by completing these tasks promptly and efficiently.
- Resolve all charges in the Charge Review Work queue daily.
- Resolve all assigned claims in the Claim Edit Work queue daily.
- Resolve all payor rejections in the Follow Up Work queue within 10 working days.
- Research and rebill/resolve all claim denials within 60 days of the date of the denial.
- Research and rebill all claims with no response from the payor within 60 days of the date billed.
- Monitor AR days for assigned departments, maintaining AR days no greater than 45 days.
- Independently work to resolve claim denials to obtain payment.
- Process appeals within the timely filing requirements of the payer contract.
- Research credit balances to determine if a refund is required. Submit refund requests as needed.
- Document all actions on accounts in the EHR with clear, complete, and accurate notes.
- Contribute to the Billing Department team through positive attitude, respectful interaction, innovative ideas, efficiency, and ethical behavior.
- Participate in educational activities and attend team meetings.
- Maintain strict confidentiality; adhere to all HIPAA and PHI guidelines/regulations.