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Claims Billing Representative

Chartwell Wisconsin
Job Description
Chartwell Wisconsin is located in Middleton and is an affiliate of UW Health.  Chartwell services patients throughout the state of Wisconsin, as well as portions of Illinois, Iowa, and Minnesota.  Chartwell offers competitive wages, flexible scheduling, casual dress code, great benefits, and the ability to work with an outstanding team. 

Position Overview
The Claims Billing Representative is responsible for the accurate and timely filing of claims to commercial, government, and contracted payers for Home Medical Equipment, CareWear, and various home health/therapy services.  The Claims Billing Representative works claim edits within Epic and/or a contracted billing software vendor timely and accurately, ensuring correct filing of insurance claims.


Position Responsibilities
  • Prepares and processes insurance claims for HME, CareWear, and home health/therapy services timely and accurately to government, commercial, and managed care payers.
  • Reviews and distributes corrected claims.
  • Enters appropriate account notes in EPIC billing system to clarify actions taken to reconcile claims.
  • Resolves claim edits via claim edit work queues and/or external billing software.
  • Corrects Medicaid claims via the WI Medicaid web portal.
  • Corrects Medicare claims via the Medicare Florida Shared System.
  • Verifies eligibility for coverage via multiple payer websites.
  • Assures compliance with billing requirements for workers compensation and third-party liability claims.
  • Collaborates with customers in planning and decision making to result in optimal solutions.
  • Understand and complies with federal and state billing regulations including protected diagnosis codes as defined under HIPAA and Wisconsin State Statutes and other regulations.


Qualifications
  • High school diploma or equivalent required.
  • Associate's Degree in Business, Finance, Health Information Management, or a related field is preferred.
  • Direct billing experience preferred.
  • Minimum of one year reimbursement and/or insurance experience required.
  • Experience in revenue cycle or EPIC preferred.
  • Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms preferred.
  • Ability to use various computer applications such as MS Office and EPIC highly desired.
  • Must have strong interpersonal, communication, and organizational skills.


Benefits
  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Short-term and long-term disability
  • Supplemental life insurance
  • 401(k) Plan
  • Flex spending
  • Paid time off


To Apply:
Submit cover letter and resume to: chartwell@chartwellwisc.com
Contact Information