PrideStaff | Job Details

Job Details

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New Berlin, WI

Salary: $16.00/hr dependent on experience and qualifi
Date Posted: December 28, 2017
Job Type: Direct Hire
Job ID: 289218

Job Description

Support Management by providing excellent customer service to our patients through the insurance reimbursement cycle.  Time management and organization are imperative as this position interacts with inside and outside customers including but not limited to patients, customer service and accounting departments, outside sales team, Medicare and other private insurance companies.


  • Print invoices from billing system.  Review invoices for completeness and accuracy according to company and department billing guidelines and insurance process.
  • Prepare invoices and patient insurance information to be entered into claims filing software.
  • Enter appropriate and necessary information into claims filing software in order to prepare required claims to be sent electronically or by paper in the mail/fax.
  • Prepare secondary or tertiary claims as necessary.
  • Review customer/patient accounts receivable/aging and take necessary steps to keep accounts current.
    • Contact insurance companies on claim status
    • Review if claims need to be sent to secondary or tertiary insurance
    • Obtain necessary documentation and provide to insurance company
    • Request refunds, write-offs as necessary
  • Review Medicare and commercial EOBs to make sure it was processed properly
    • Contact insurance companies or submit corrected claims as necessary
    • Submit requests to write-off agreed amount contractual write-offs
    • Prepare and submit necessary appeals
  • Communicate with Financial Controller as needed with regard to discrepancies and complaints.
  • Works cooperatively with Customer Service and Customer Support Group in order to help expedite patient orders.  Assist in verifying Medicare or private insurance eligibility.
  • Answer incoming calls from patients and clinicians about the reimbursement process using appropriate customer service skills and in a professional, knowledgeable, and courteous manner.
  • Maintain current files and billing records, and make changes as needed so that patient information on file is accurate and complete.
  • Follow-up on incomplete or missing insurance information from patients or clinicians.
  • Provide reports on billing activities as requested by Financial Controller.
  • Establish and maintain required billing records and patient insurance information according to Medicare, HIPAA and other department guidelines.
  • Participate in surveys conducted by authorized inspection agencies.
  • Participate in Company’s Performance Management Program as requested by the Performance Management Coordinator.
  • Pursue continuing education programs appropriate to job responsibilities.
  • Contribute to a positive work climate and overall team effort within the Company.
  • Backup other Insurance Specialists in Department.
  • Perform other duties as assigned by Financial Controller.
  • Some travel may be required.

An individual in this position must be able to successfully perform the essential duties and responsibilities listed above.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position. 

The above list reflects the general details necessary to describe the principle and essential functions of the position and shall not be construed as the only duties that may be assigned for the position. 


  • Must be assertive and well-organized with strong computer and excellent phone, written and customer service skills and etiquette with a professional attitude. 
  • Ability to work in a team environment a must. 
  • Ability to manage multiple tasks, prioritize them and pay attention to detail. 
  • Demonstrated PC and keyboarding skills that include word processing, efficient use of internet and email, and Microsoft Office. 
  • Participates in educational activities.
  • Organizational skills sufficient to maintain consistently accurate records.
  • Ability to recognize and direct information to the appropriate health care provider.
  • Health insurance billing experience




  • High school diploma or equivalent



  • Education:  Associates Degree
  • Experience: 2 + years of background in customer service in a health care related industry. Demonstrated proficiency in phone skills (professional attitude, clear intelligible communication), cross-trained in key areas identified by department manager, ability to work independently and set priorities. Possess effective interpersonal and communication skills.
  • Licenses/Certifications: PC literate. Knowledge of Lotus Notes and Microsoft Office Programs highly recommended



  • Two years medical billing and customer service experience
  • Exceptional customer focus and ability to work under pressure; ability to maintain awareness of, and seek to meet the needs and wants of the customer without being prompted



Medical Billing and/or Reimbursement


  • While performing the duties of this job, the employee is frequently required to sit and or stand. 
  • Requires the ability to remain stationary for extended periods of time.
  • Some lifting, bending, and grasping of product and or files. 
  • Ability to walk, crouch, kneel, or stoop; use hands to finger, handle, or feel objects, equipment, or controls, and talk and hear.
  • Occasionally, the employee is required to climb, balance and crawl.
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
  • Continuously view computer screen in performance of duties (may differ as position in department dictates). 
  • The employee must occasionally lift up to 20 pounds


The mental and physical requirements described here are representative of those that must be met by an individual to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.