Job DetailsJob Location: GRAFTON, WI 53024Salary Range: $19.00 - $23.00 Hourly Claim Submission: Prepare, review, and submit claims for services provided to adults with I/DD, ensuring accuracy and completeness. Denial Management and Appeals: Monitor unpaid and denied claims, research the reasons for denial, make necessary corrections, and file appeals with payers as appropriate to ensure timely reimbursement. Accounts Receivable Management: Manage and follow up on accounts receivable aging, post payments, debits, and credits accurately, and work with Program Managers regarding co-pays or outstanding balances. Compliance and Reporting: Maintain up-to-date knowledge of all Medicaid regulations and billing guidelines (including HIPAA), assist in audits, and prepare reports for management on billing activities and financial performance. Collaboration and Communication: Serve as a liaison, communicating effectively with internal staff and external parties to resolve issues and ensure smooth processes. Specialized Knowledge: Understand alternative integrated models and specific service delivery methods relevant to individuals with I/DD to ensure proper billing and maximize eligible reimbursements. Wisconsin Family Care Position is 18-25 hours a week Qualifications Experience: Previous experience (typically 1-2 years minimum) in specialized billing, claims processing, and accounts receivable follow-up is required. Experience working within a nonprofit or with individuals with I/DD is often preferred. Knowledge: Strong knowledge of Medicaid, and funding source agencies strongly encouraged Technical Proficiency: Competence in using billing software, and Microsoft Office Suite (especially Excel). Soft Skills: Excellent attention to detail, strong analytical and problem-solving skills, good organizational and time management abilities, and effective communication skills are essential for success in this role. Take Initiative!!!
Learn more about this Employer on their Career Site
