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Account Resolution Rep II PB
Children's Wisconsin
West Allis, USA
Full-time
Mid · 3+ years experience
Onsite
Discovered 2 weeks ago
Communication
Role Overview
Researches and resolves Professional Billing complex service insurance denials and ensures that claims are paid at maximum reimbursement from third party payers, state programs and contracted organizations for Children's Wisconsin.
Key Skills for This Role
Communication
Full Job Posting
Experience
- 3 years experience in claims follow up in health care revenue cycle operations including reimbursement procedures and comprehension of insurance EOB’s required
- Prior experience in a hospital system working with professional billing claims and functions preferred
- Inpatient and surgical medical billing experience preferred
- Mental Behavioral Health billing experience preferred
- Experience in Epic Resolute preferred
- Knowledge, Skills and Abilities:
- Working knowledge of medical terminology, ICD-10, CPT and HCPCS level II codes.
- Strong understanding of payer guidelines, policies and procedures.
- Excellent verbal and written communication skills.
- Ability to work independently with minimal supervision.
- Strong analytical skills and ability to perform noncomplex arithmetic calculations when determining contractual allowances.
- Must have working knowledge of account reconciliation and third party reimbursements from Commercial, Medicaid and Medicare Carriers.
- Interpersonal skills necessary to efficiently respond to questions from patients, parents, clinic staff and insurance companies to effectively resolve billing issues.
- The ability to multi-task and function effectively in a team environment and maintain effective relationships with coworkers, patients, physicians, management, staff and other customers.
- Proficient in Microsoft Office applications and technology skills required to perform duties.
- Required for All Jobs:
- This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.
- Employment is at-will. This document does not create an employment contract, implied or otherwisre.
- Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.
- Certifications/Licenses
Preferred Qualifications
- Prior experience in a hospital system working with professional billing claims and functions preferred
- Inpatient and surgical medical billing experience preferred
- Mental Behavioral Health billing experience preferred
- Experience in Epic Resolute preferred
About Children's Wisconsin
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