Children's Wisconsin is a pediatric health system focused on the health and well-being of children and families. This role supports hospital billing operations by resolving government, Medicaid HMO, and commercial insurance claims, investigating denials and payment issues, and ensuring accounts are accurately paid and balanced.
The position works with Epic, payer websites, and eligibility tools to follow up on unpaid or underpaid claims, correct and resubmit claims, manage credit balances, support refund requests, and escalate trends or unresolved issues to leadership. The role also includes validating release of information requests and helping protect the organization's financial interests.
Required
- High school diploma, GED, or HSED
- 2+ years of experience in claims follow-up, HCFA/UB-04 claims, and insurance reimbursement procedures
- Strong comprehension of insurance EOBs
- Basic knowledge of medical records and HIPAA
- Basic understanding of medical terminology, anatomy, disease processes, ICD-10, CPT, and HCPCS Level II codes
- Strong attention to detail and accuracy
- Strong problem-solving and communication skills
- Ability to prioritize, organize, meet deadlines, and work independently
- Proficiency with Microsoft Office, Adobe, email, electronic health records, and keyboarding
Preferred
- Associate's degree or higher in Medical Billing and Coding, Health Information Management, Healthcare Services Management, or Health Information Technology
- Associate's degree in a business-related field
- Pediatric or pediatric subspecialty experience
- Prior Epic experience
Perks
- Remote position
- Flexible schedule
Location
Wisconsin, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
3 weeks ago