Patient Services Representative

Insurance Claims Billing Specialist

Prepares and submits properly executed claims to appropriate payers on a timely basis while ensuring payer-specific billing requirements are met. Verifies insurance eligibility while resolving any issues related to open claims to ensure an accurate and timely payment. Follows up on billing, reviews denials, submits appeals and reconsiderations as needed, determines and applies appropriate adjustments, answers inquiries and updates accounts, as necessary. Performs other related duties as requested.

Minimum Education Required

High School or Equivalent (GED)

Minimum Experience Required

Must have at least six (6) months of hospital billing experience.

Knowledge, Skills & Abilities Required

Ability to read, write, hear, speak, and comprehend the English language. Requires exceptional communication skills and the ability to deal with people in all levels of society in a calm, courteous manner. Ability to handle fluctuating daily work assignments based upon changes in patient census volume. Business Office experience in a health care environment in Billing, Customer Service, insurance follow-up, or Collections is preferred. Knowledge of telephone etiquette, typing, computer, calculator, copy machine, web-based applications, and the use of a fax machine. Ability to walk, sit, stand, bend, push, and lift weights of up to 25 pounds for up to 5% of the workday.

Principal Responsibilities and Essential Duties

Independently performs all aspects of insurance claims billing, follow-up work, and appeals, including accessing, retrieving, and inputting information throughout the claims processing cycle. Understands and applies knowledge of medical billing, terminology, and coding. Reviews account documentation, records, and supporting information to ensure accurate and appropriate billing and claim reimbursement. Practices positive communication skills and is able to successfully interact with all patients and staff including the use of proper telephone etiquette. Continually demonstrates courteous, cooperative and service-oriented manner following hospital policies. Performs clerical functions while maintaining current accounts accurately and timely, utilizing computer, calculator, copier, fax machine, and web-based application knowledge. Effectively keeps current on billing guidelines, memos, correspondences, reports, and work queues.

Location: Froedtert South, Inc. Patient Accounting Schedule: Full-time, Days, 80