POSITION SUMMARY:

The Billing, Claims & Reimbursement Specialist is responsible for a portfolio of insurance accounts receivable and is engaged in proactive billing and collection of outstanding balances, including accurate and timely filing of claims and processing of appeals, with government or third-party payors. The Claims & Reimbursement Specialist will ensure correct and appropriate information is on a claim and will promptly handle resolution of outstanding balances, which involves working with UW Health internal and external customers (e.g. third party payers, estate representatives, attorneys, clinicians, employers, and UW Health employees). Additionally, this position requires a thorough understanding of often complex contracts, third party payer requirements, government regulations, and in-house computer applications for billing and accounts receivable.

This position represents UW Health in northern Illinois and the Revenue Cycle team by adhering and upholding the UW Health Respect for People Commitments and Service Excellence Standards of Behavior in providing the highest quality service to our customers. They will be friendly, knowledgeable, flexible, and reliable. They will listen to, anticipate, recognize, and satisfy our customer's needs. We will improve our collections while ensuring the highest level of satisfaction, keeping our promises and commitments, and demonstrating our commitment through respect, knowledge, responsiveness, and courtesy. They will support their co-workers, engage in positive interactions, demonstrate friendliness by smiling and making eye contact when greeting all customers, provide helpful assistance in anticipating and responding to the needs of our customers and staying calm under pressure to deal effectively with difficult people.

EDUCATION/TRAINING:

High school diploma or GED preferred. At least 2 years experience in healthcare or related field with emphasis on insurance billing and insurance claim follow-up processes.

LICENSURE/CERTIFICATION:

N/A

EXPERIENCE/SKILLS/ABILITIES:

• Excellent customer service, interpersonal and organizational skills
• Ability to use good judgments in demanding situations
• Ability to react to frequent changes in duties and volume of work
• Effective communication skills
• Ability to listen empathetically
• Ability to logically and accurately organize details
• Ability to manage multiple tasks with ease and efficiency
• Self-starter with a willingness to try new ideas
• Ability to work independently with minimal supervision and be result oriented
• Positive, can-do attitude coupled with a sense of urgency
• Effective interpersonal skills, including the ability to promote teamwork
• Strong problem-solving skills
• Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders
• Excellent computer operating skills (keyboard, mouse)
• Ability to use various computer applications including EPIC and MS Office
• Basic math skills and knowledge of general accounting principles
• Maintains confidentiality of sensitive information
• Broad knowledge of health care business office practices and principles
• Knowledge of medical and insurance terminology, EOB’s, CPT, ICD coding structures, and billing forms (UB, 1500)
• Knowledge of Business Office policies and procedures
• Knowledge of local, state and federal healthcare regulations

Our Commitment to Diversity, Equity, and Inclusion

UW Health is committed to being a diverse, inclusive and anti-racist workplace and is an Equal Employment Opportunity, Affirmative Action employer. Our integrity shines through in patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. Applications from Black, Indigenous and People of Color (BIPOC) individuals, LGBTQ+ and non-binary identities, women, persons with disabilities, military service members and veterans are strongly encouraged. EOE, including disability/veterans.