Billing Specialist I

Billing Specialist I

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, you will be responsible for correcting claim errors and completing the claim submission process for all payers. Your duties will include, but are not limited to : validating registrations, obtaining accurate insurance information to coordinate benefits, performing data entry, clear validation edits, and providing process improvement suggestions for issues identified in the claims submission process. You will also analyze, research, and release insurance claims to be submitted to insurance carriers in a timely and accurate manner using the patient accounting system.

Essential Duties & Responsibilities :

• Gathers and / or verifies patient information to validate insurance coverage and confirms patient eligibility for dates of service. Reviews daily registration report, claim validation reports, and encounter holds to ensure early turnaround of accounts receivable.
• Reviews errored claims for eligibility in the clearinghouse to ensure early turnaround of accounts receivable. Deletes claims in the clearinghouse and cancels claims in the patient accounting system to regenerate claims in the patient accounting system.
• Applies same-day holds for patients who have multiple visits to the facility on the same day.
• Posts manual charges, processes anesthesia procedure entries, and releases respiratory and cardiac charges.
• Reviews discharged not-final-billed work queue to release holds as directed.
• Processes printed paper claim forms from the clearinghouse and mails them with appropriate documentation in a timely manner.
• Completes validation edits for missing insurance numbers by either verifying eligibility or sending appropriate letters to patients when information is needed for submitting claims to the appropriate insurance carrier.
• Performs tasks to support the department, including processing and routing all incoming and outgoing mail.
• Other job duties as assigned.

Supervisory Responsibilities :

No direct reports

Skills and Experience :

Required :

Preferred :

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.