Winona Health
Billing Specialist II
As the Billing Specialist II, you will be responsible for correcting claim errors and managing the claim submission process for all payers. Your duties will include, but are not limited to: reviewing and resolving claim pre-submission edits, rejections, and providing process improvement suggestions for improving the clean claim rate. Additionally, you will analyze, research, and resubmit claim rejections by insurance, and follow up on past-due claims. Essential duties and responsibilities include: Claim Review and Resolution: Review errored claims and resolve pre-submission edits and rejections to ensure timely filing of claim processing. Correct issues in the clearinghouse and resubmit the claims to insurance for payment. Rejection Management: Analyze, research, and resubmit insurance claim rejections to ensure proper resolution and reimbursement. Claim Follow Up: Follow up on past-due claims, ensuring that outstanding issues are addressed and claims are resubmitted promptly to meet timely filing guidelines. Documentation and Communication: Preparing paper claims, mailing them with required documentation, and interacting with patients and insurers to confirm eligibility and address concerns. Process Improvement: Provide suggestions of improvements to increase the clean claim rate, identifying patterns in claims rejections and suggesting enhancement in the claim submission process. Backup to all the duties of the Billing Specialist I position. Other job duties as assigned by management. Supervisory responsibilities include: No direct reports Skills and experience required: High school diploma or equivalent Basic computer skills: Microsoft Word, Excel, Outlook, and Teams Strong attention to detail to accurately interpret claims and resolve issues Basic math skills for calculating rates, percentages, and other billing-related functions Effective communication skills for liaising with insurance companies, patients, and colleagues Ability to work independently, handling different aspects of the billing process without direct supervision Preferred: Previous billing experience is preferred but not required Summary of benefits at Winona Health: At Winona Health, we are dedicated to offering a comprehensive and affordable benefits package for our employees and their families. While benefits may vary based on employment classification and job status, the following key benefits are available: Health Insurance: Options for medical, dental, and vision coverage, as well as mental health support and wellness incentives Income Protection: Short and long-term disability, plus additional benefits like accident, critical illness, hospital indemnity, legal assistance, and identity protection plans Retirement Planning: Access to a 403(b) retirement plan with employer contributions once eligibility requirements are met Work/Life Balance: Flexible scheduling, paid time off, and earned sick time to support personal well-being Education & Development: Paid training, tuition reimbursement, scholarships, and sponsored seminars to foster both personal and professional growth Employee Discounts: Special offers with local businesses, including the YMCA and cell phone providers For more details or specific information, visit our website or contact Human Resources.
As the Billing Specialist II, you will be responsible for correcting claim errors and managing the claim submission process for all payers. Your duties will include, but are not limited to: reviewing and resolving claim pre-submission edits, rejections, and providing process improvement suggestions for improving the clean claim rate. Additionally, you will analyze, research, and resubmit claim rejections by insurance, and follow up on past-due claims. Essential duties and responsibilities include: Claim Review and Resolution: Review errored claims and resolve pre-submission edits and rejections to ensure timely filing of claim processing. Correct issues in the clearinghouse and resubmit the claims to insurance for payment. Rejection Management: Analyze, research, and resubmit insurance claim rejections to ensure proper resolution and reimbursement. Claim Follow Up: Follow up on past-due claims, ensuring that outstanding issues are addressed and claims are resubmitted promptly to meet timely filing guidelines. Documentation and Communication: Preparing paper claims, mailing them with required documentation, and interacting with patients and insurers to confirm eligibility and address concerns. Process Improvement: Provide suggestions of improvements to increase the clean claim rate, identifying patterns in claims rejections and suggesting enhancement in the claim submission process. Backup to all the duties of the Billing Specialist I position. Other job duties as assigned by management. Supervisory responsibilities include: No direct reports Skills and experience required: High school diploma or equivalent Basic computer skills: Microsoft Word, Excel, Outlook, and Teams Strong attention to detail to accurately interpret claims and resolve issues Basic math skills for calculating rates, percentages, and other billing-related functions Effective communication skills for liaising with insurance companies, patients, and colleagues Ability to work independently, handling different aspects of the billing process without direct supervision Preferred: Previous billing experience is preferred but not required Summary of benefits at Winona Health: At Winona Health, we are dedicated to offering a comprehensive and affordable benefits package for our employees and their families. While benefits may vary based on employment classification and job status, the following key benefits are available: Health Insurance: Options for medical, dental, and vision coverage, as well as mental health support and wellness incentives Income Protection: Short and long-term disability, plus additional benefits like accident, critical illness, hospital indemnity, legal assistance, and identity protection plans Retirement Planning: Access to a 403(b) retirement plan with employer contributions once eligibility requirements are met Work/Life Balance: Flexible scheduling, paid time off, and earned sick time to support personal well-being Education & Development: Paid training, tuition reimbursement, scholarships, and sponsored seminars to foster both personal and professional growth Employee Discounts: Special offers with local businesses, including the YMCA and cell phone providers For more details or specific information, visit our website or contact Human Resources.