Billing Specialist II

Billing Specialist II

Business Services Department

1.0 FTE, 80 Hours a Pay Period

Days, Hours between 7:30 am - 4:00 pm

Weekends: No

Holidays: No

Telecommute Available: No

Position Overview:

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 clean claim rate. Additionally, you will analyze, research, and resubmit claim rejections by insurance, and follow up on past-due claims.

Essential Duties & Responsibilities:

• 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:

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

Internal Applicant Policy:

It is the policy of Winona Health to work with employees in an equitable fashion regarding promotions, transfers, and position reclassifications.

Any employee wishing to apply for another available position at Winona Health must submit an application for consideration through the internal application portal. Employees requesting to change positions should have successfully completed at least six (6) months in their current position. Employees currently in the formal disciplinary process may be required to meet with the Director of Human Resources to determine eligibility to request transfer. The employee's past performance, experience, training and qualifications will be considered in transfer/hiring decisions. Consideration for transfer or promotion is not a guarantee of transfer or promotion. Employees may be given a chance to interview for a position when they meet the minimum position qualifications.

Disclaimer:

Winona Health is an equal opportunity employer. Winona Health does not refuse to hire, discharge, or discriminate against a person with respect to tenure, compensation, terms, upgrading, conditions, facilities, or privileges of employment because of race, color, creed, religion, sex, age, national origin, marital status, genetic information, status with regard to public assistance, membership in a local discrimination commission, sexual orientation, disability, veteran status, or any other prohibited basis of discrimination under applicable local, state, or federal law. Winona Health does not tolerate retaliation against any employee, patient/resident, physician, or other individuals pursuing concerns regarding Civil Rights issues. Winona Health adheres to ALL pertinent governmental policies and legislation including the Civil Rights Act of 1964, Title VII, as amended, and the Minnesota Human Rights Act.