Patient Billing Representative

Job Description

Job Description

Patient Billing Representative Opportunity:

The Patient Billing Representative is responsible for accurate and timely billing of inpatient, outpatient, and ancillary services to commercial insurers, Medicare/Medicare Advantage, Medicaid/Medicaid HMOs, Workers’ Compensation/Liability carriers, and self-pay accounts. This position monitors accounts receivable, follows up on denials and underpayments, and ensures compliance with payer requirements, regulations, and organizational policies. The role also provides customer service to clients, families, and external parties regarding billing inquiries, payment arrangements, and account resolution.

What You’ll Get:

• The starting pay range for this role is $21.73 -$23.67 based on education and experience.
• This job is a full-time, in person position, usually working weekday business hours.
• PTO, paid holidays, health insurance, dental insurance, vision insurance, on-site bistro and cafeteria, employee assistance program, newly updated facility, and more.
• As a full-time employee of NCHC, you are eligible for the Wisconsin Retirement System (WRS). The WRS is a hybrid defined benefit plan. It contains elements of both a 401(k) or defined contribution plan and a defined benefit plan. Participating staff contribute 7.2% and NCHC will match this at 100% each pay period!

What You Bring:

Required:

• High school diploma or equivalent.
• Minimum of 1 year of experience in healthcare billing or revenue cycle functions.
• Applicants must be authorized to work in the United States without the need for current or future employer sponsorship, including but not limited to visa sponsorship or employment-based immigration support.

Preferred:

• Associate degree in Health Information, Business, or a related field.
• Experience with behavioral health billing and multiple payer types.

In evaluating candidates for this position, North Central Health Care may consider a combination of education, training, and experience which provides the necessary knowledge, skills, and abilities to perform the duties of this position.

What an Patient Billing Representative does at NCHC:

• Prepare and submit accurate claims to third-party payers and self-pay clients, ensuring compliance with payer rules and filing deadlines.
• Rebill claims when necessary; submit secondary and corrected claims electronically or on paper as required.
• Process refunds as necessary.
• Audit self-pay bills to confirm accuracy and compliance with Wisconsin Administrative Code.
• Monitor accounts receivable aging; research and resolve unpaid claims over established time thresholds.
• Review payments, denials, and explanation of benefits (EOBs) for accuracy and appropriateness.
• Initiate appeals, adjustments, transfers, write-offs, and refunds in accordance with policy.
• Collaborate with collection agencies, when applicable, to ensure proper handling of accounts.
• Investigate and resolve claim denials, underpayments, or incorrect reimbursements.
• Communicate with insurance companies, providers, and internal departments to resolve billing and authorization issues.
• Respond to client inquiries via phone or email, providing explanations of charges and account balances.
• Communicate with external customers and families to provide itemized statements or resolve billing questions.
• Work closely with Patient Access, Health Information Management, Utilization Review, Credentialing, and other departments to ensure accurate payer setup and claim resolution.
• Process bankruptcy and probate according to established guidelines
• Perform other duties as assigned.

Working Environment and Physical Requirements

• Primarily indoor office setting with frequent use of computers, phones, and office equipment.
• Moderate background noise; occasional tight spaces/close quarters.
• Prolonged sitting; occasional standing, walking, bending, or reaching.
• Frequent repetitive hand motions (typing, data entry).
• Occasional interaction with individuals who may be agitated or upset.
• Minimal exposure to hazards or infectious agents.

Who We Are:

Nestled in the heart of Central Wisconsin, North Central Health Care (NCHC) is a healthcare organization formed over fifty years ago as a partnership between three Central Wisconsin counties - Langlade, Lincoln, and Marathon. NCHC employs more than 600 professionals in diverse roles across a variety of care and work environments. We provide passionate and high-quality care for individuals and families within the fields of mental health treatment, addiction services, long term care, short term care, physical therapy, crisis stabilization and so much more. We have amazing employees who provide exceptional care and want to add to our team. You can visit our website at to learn more.

In compliance with the American with Disabilities Act, NCHC will provide reasonable accommodations to qualified individuals and encourages both prospective and current employees to discuss potential accommodations with the employer. North Central Health Care is an Equal Opportunity Employer.