Billing Specialist

Lutheran Social Services of WI and Upper MI is currently seeking a full-time Billing Specialist to join our team. As a member of the Billing & Collections Team, the Billing Specialist provides excellent customer service to all of those involved in the LSS revenue cycle including program staff, payers, and clients. This position is responsible for maintaining timely and accurate reimbursement of billing information. This position will actively participate and share in the responsibility of maintaining a low percentage of Accounts Receivable over 90 days as well as accomplish all collection goals. As a member of the Billing & Collections Team, the Billing Specialist will work and support the following disciplines: Billing and A/R Follow-up and/or Cash Application. The area(s) of focus will be dependent on business need.

This is a benefit eligible opportunity with the possibility of a hybrid-remote schedule. Please note, hybrid employees must reside in Wisconsin.

Essential Duties and responsibilities:

This list of duties and responsibilities is not all-inclusive and may be expanded to include other duties and responsibilities, as management may deem necessary from time to time.

General

• Document and maintain consistent workflow processes and procedures to enhance workflow and efficiencies to ensure maintaining accuracy.
• Participate in training of billing specialists.
• Participate in cross-training and learning new disciplines of the revenue management cycle.
• Understand the various programs and services provided within LSS.
• Ability to maintain a high level of confidentiality and follow all LSS rules and regulations pertaining to HIPAA laws.
• Must comply with agency and department policies.
• Must relate to individuals and families of varied ethnic and cultural backgrounds, ages, and economic circumstances with respect and dignity.
• Must support the Mission, Vision, and Values of the Agency.
• Maintain records and accurate filing systems.
• Participate in projects and other duties as assigned and needed.

Billing and A/R Follow-up:

• Process timely claims and review claims for accuracy in collaboration with Quality Assurance (QA) staff for a variety of payers, including County, State, Medicaid, Medicare, commercial insurance, and self-pay, utilizing different methods of submission.
• Review monthly Unbilled Report for any held claims that did not bill for the month and investigate the reason it was held.
• Process denials and determine if a claim needs to be re-submitted or if an appeal needs to be made with the payer within established time frames to ensure timely filing.
• Resubmit claims as necessary.
• Follow-up with insurance or other payers to resolve outstanding billing issues.
• Validate and process all payer appeal requests and client adjustments.
• Responsible for collection of assigned Accounts Receivables, following all procedures and guidelines as established.
• Contact insurance companies, government agencies, and clients regarding unpaid claims.
• Review claim information to ensure claims are paid and accounts are properly balanced, reconciling any billing or payment discrepancies. Apply contractual adjustments where necessary.
• Identify and report any bad debt, billing or collection issues upon discovery
• Run Accounts Receivable aging reports, as necessary.
• Provide timely updates on outstanding collections for company reporting.
• Prepare necessary write off requests for indigent clients, untimely filing, etc., and forward to management for approval.
• Perform and document collections activity with a goal of maximizing Agency collections.
• Run billing reports as needed or requested by management.

Cash Application:

• Prepare daily bank downloads.
• Post reimbursements both electronically and manually.
• Research discrepancies related to cash receipts/posting and assist with resolution.
• Create daily bank deposit batches and run daily banking report.
• Create journal entries in GL system by entering daily deposit.
• Run billing reports as needed or requested by management.

PERKS:

• Public Service Loan Forgiveness (PSLF)
  
  
  
  • By being employed with LSS, which is a non-profit agency, you can be eligible for loan forgiveness under the Public Service Loan Forgiveness program.
  • Loans are eligible to be forgiven after 10 years of on-time and consistent payments through the income-based re-payment plan.
  • Assistance navigating the PSLF through Summer
  
  
  
  
• Medical/Dental/Vision Insurance
• Flex Spending for Dependent & Health Care
• Mileage reimbursement
• Paid Time Off
• 10 Paid Holidays
• Ability to Contribute to 403B
• LSS makes annual raises a priority for employees
• Calm Wellness App - Premium Access
• Early Earned Wage Access with UKG Wallet
• Employee Assistance Program
• Service Awards and Recognition

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Upon offer, candidates must successfully complete the necessary background, caregiver, medical and any other checks required, according to program requirements. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND/OR EXPERIENCE

• High School diploma, associate's degree or higher in accounting field preferred;
• Minimum of 1+years medical billing experience is required;
• Working knowledge of insurance Explanation of Benefits (EOB's);
• Sound knowledge of ICD coding including modifiers and electronic billing for Medicare, Medicaid and other payers;
• Knowledge and experience posting charges and payments;
• Ability to work collaboratively with individuals in other departments;
• Knowledge of Word, Excel and Outlook; ability to learn computer software;
• Strong verbal and written communication skills;
• Able to work independently and stay on task to meet deadlines;
• Able to work overtime when warranted such as month end tasks;
• Skill in adding, subtracting, multiplying, and dividing whole numbers, fractions, and decimals with a calculator;
• Skill in analyzing information, problems, situations, practices or procedures to: define the problem or objective; Identify relevant concerns or factors; Identify patterns, tendencies and relationships; Formulate logical and objective conclusions; Recognize alternatives and their implications.
• Outstanding customer service skills.

CERTIFICATES, LICENSES, REGISTRATIONS: N/A

LANGUAGE SKILLS:

To perform this job successfully, an individual should:

• Ability to communicate both in verbal and written format, effectively and efficiently in job is required.
• Ability to write routine reports and standard documentation.
• Ability to speak effectively to vendors and other employees of the organization.

COMPUTER SKILLS/TECHNOLOGY:

To perform this job successfully, an individual should have:

• Working knowledge of computers to allow employee to access computer systems and applications to complete timecards, read and respond to email, and complete required on-line training.
• Have knowledge of Microsoft Office (Word, Excel, Outlook, Teams, and PowerPoint) and the ability to quickly learn new software programs.
• Must be able to work on computer and utilize computer applications and programs to effectively complete the job.
• Ability to work within a variety of ever-changing software packages and computer systems.
• Create and edit complex documents, spreadsheets, presentations, etc.
• Maintain records and accurate filing systems.
• Regular use of technology for meetings and communication to include email, conference calls, web-based meetings, and webinars.

PHYSICAL DEMANDS/WORK ENVIRONMENT:

The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or touch objects, tools, or controls. The employee frequently is required to talk or hear. The employee is occasionally required to stand; walk; and stoop, kneel, or crouch. The employee must occasionally lift and/or move up to 25 pounds, carrying and moving payroll records and printer paper. Specific vision abilities required by this job include close vision and the ability to adjust focus.

The incumbent will be primarily remote, and in accordance with management discretion.

TRAVEL: Ability to travel on day trips as required but would not be often. Some overnight travel may be required.

LSS is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, disability status or any other characteristic protected by federal, state or local law.