Quad/Graphics Billing Specialist - Sussex in Sussex, Wisconsin
QuadMed's dedicated health professionals focus on wellness and prevention, putting the patient at the center. Working as a team, we deliver high quality, integrated care while controlling ever-growing costs. QuadMed is an innovative leader in employer healthcare solutions, one of the fastest growing providers in the country. In partnership with our patients and the companies we serve, our mission is to create a culture of health.
Reports directly to the Revenue Cycle Supervisor. Responsible for the review and submission of professional claims to third party payers, claims edits and resubmissions, organizations of payer responses, payment posting from EOBs or remits and patient payment, creating and transmitting patient statements, ability to answer patient questions about accounts and provide outstanding customer service.
This position will be working out of our Call Center in Sussex, working Monday through Friday 8am-4:30pm. Not a work from home role.
KEY RESPONSIBILITIES In order of importance
Batches and transmits paper and electronic claims
Assesses claims to verify correct billing
Completes assigned systematic checks to ensure all billable claims are transmitted and processed in a timely manor
Manually and electronically post remits from third party payers
Verifies all systems are balanced at the end of the date of service
Corrects, both preemptively and post submission upon denial or rejection, claims errors
Follows up on unpaid claims within the standard revenue cycle timeframe
Works collaboratively with management to create and analyze tracking reports to evaluate trends
Maintains a solid understanding of current medical billing rules, laws and regulations
SCOPE Will work collaboratively with clinical, medical billing and coding staff, supporting health and wellness center based staff as well as corporate staff based on client needs.
JOB REQUIREMENTS A working knowledge of; current medical billing, coding and collections rules and requirements, ability to work in a team environment, efficiently, and accurately, a strong understanding of healthcare compliance to regulations including HIPAA, OIG, and AMA rules and guidelines.
Education: High school diploma required
Knowledge, Skills & Abilities:
3 years of medical billing experience preferred, Epic background preferred
Experience in medical billing or medical administration preferred
A working knowledge of insurance guidelines
Effective communication skills
Strong ethics and a high level of personal and professional integrity
We offer excellent benefits to eligible employees, including 401(k), holidays, vacations and more. In select states, patient care is provided by an independent physician-owned corporation. Quad/Graphics is an equal employment opportunity employer. The Company’s policy is not to unlawfully discriminate against any applicant or employee on the basis of race, color, sex, sexual orientation, gender identity, religion, national origin, age, military or veteran status, disability, genetic information or any other consideration made unlawful by applicable federal, state, or local laws. The Company also prohibits harassment of applicants and employees based on any of these protected categories. Drug Free Workplace