A Billing Specialist performs administrative work at financial institutions and banks that handle bills, receipts, and invoices. Manages the status of client accounts and tracks financial records, charges, and receipts of the accounts.
MCO Billing Specialist Embark Support Employment Superior, WI Job Details Part-time $18 - $20 an hour 10 hours ago Benefits Flexible schedule Qualifications Managed care Managed care organization experience HIPAA High school diploma or GED Attention to detail Productivity software Associate's degree Full Job Description Come join our team at Embark! We are seeking an experienced MCO Billing Specialist to join our organizaiton. Flexible hours (10-15 hours per week)
Pay:
$18 - $20/hour Job Summary The MCO Billing Specialist is responsible for the accurate and timely billing, follow-up, and collection of claims submitted to managed care organizations. This role ensures compliance with payer-specific requirements, resolves claim denials and rejections, and supports the organization's revenue cycle by minimizing aging accounts receivable. Responsibilities Prepares, reviews, and submits clean claims to managed care payers via electronic and paper submission Verifies member eligibility, benefits, and authorization requirements prior to claim submission Researches, corrects, and resubmits denied, rejected, or underpaid claims within payer timely-filing limits Posts payments, adjustments, and denials Reconciles remittance advices (ERA/EOB) against expected reimbursement. Monitors accounts receivable aging and conducts proactive follow-up on outstanding claims Maintains current knowledge of payer contracts, fee schedules, and MCO-specific billing rules Communicates with payers, providers, and internal departments to resolve billing discrepancies Documents all account activity accurately in the billing/practice management system. Ensures compliance with HIPAA, payer guidelines, and applicable state and federal regulations Assists with month-end reporting and identifies trends in denials or reimbursement issues Consults with claim clerks at each MCO about any disputed claims and follows up on all bills not processed within the usual claim period. Prepares weekly and monthly reports of MCO billing Competencies Attention to detail, analytical problem-solving, organization, and clear written/verbal communication. Required Qualifications High school diploma or equivalent; associate's degree in a related field preferred 2+ years of billing experience, with direct managed care/MCO claims experience Knowledge and experience using Microsoft Office products Affirmative Action/EEO statement Embark Supported Employment employees and job applicants are protected from discrimination based on race, color, religion, sex, parental status, national origin, age, disability, genetic information, political affiliation, military service, or other non-merit-based factors. These protections apply to all employment decisions, including recruitment, hiring, performance evaluations, promotions, training, and career development. Additionally, Embark Supported Employment provides to employees and applicants reasonable accommodations for disabilities; for pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.
Pay:
$18.00 - $20.00 per hour Expected hours: 10.0 - 15.0 per week
