Full job description
Medical Billing Specialist

Tenderness Health Care | Shorewood, WI
Full-Time
Pay Range: $23–$25/hr based on experience

Office location:

Shorewood — 3569 N Oakland Ave, Suite B, Shorewood, WI 53211

Milwaukee — 823 S Layton Blvd, Milwaukee, WI 53215

For more than 15 years, Tenderness Health Care has been committed to providing quality care while building a workplace where employees feel valued, respected, and supported.

As we continue to experience rapid growth and expand our healthcare services, we are creating new opportunities for talented professionals who want to grow with us.

We are looking for an A+ team player who takes pride in their work, values teamwork and accountability, and is excited to build a long-term career with an established and growing healthcare organization.

At Tenderness, your work matters, your contributions are appreciated, and there is opportunity to grow as we grow.

Position Summary

The Medical Billing Specialist will support billing, revenue-cycle, authorization, and related operational processes.

This position helps ensure services are billed accurately and timely, outstanding claims are followed through to resolution, authorizations and recertifications are properly tracked, and billing-related workflows remain organized.

The ideal candidate is detail-oriented, dependable, comfortable working across multiple systems, and able to take responsibility for tasks from beginning to completion.

Medical Billing & Revenue Cycle Responsibilities

Prepare, review, and submit healthcare claims accurately and timely
Review billing information for completeness and accuracy before submission
Cross-check billable services against submitted claims
Review billable hours for accuracy and completeness
Identify services that have not yet been billed
Monitor rejected, denied, unpaid, and underpaid claims
Research billing issues and follow them through to resolution
Correct and resubmit claims when necessary
Follow up with insurance companies and payors regarding outstanding claims
Review accounts receivable and aging reports
Assist with payment posting and reconciliation
Verify eligibility and applicable payer requirements as needed
Confirm required authorizations are in place before billing
Review EVV and service information for billing discrepancies
Identify missing or incorrect information that could delay payment
Maintain detailed and accurate billing notes
Assist with denial management and payment follow-up
Escalate unresolved billing issues when appropriate
Billing Oversight & Reporting

Prepare and maintain weekly billing reports
Perform billing cross-checks and identify discrepancies
Review billing activity to help ensure eligible services are captured
Track outstanding claims and follow-up activity
Monitor billing-related tasks through completion
Review accounts receivable reports
Identify recurring billing issues and trends
Communicate billing concerns to the appropriate departments
Assist with improving billing workflows and internal processes
Help ensure billing deadlines and internal expectations are met
Authorizations, Referrals & Recertifications

Manage assigned clients through administrative portions of the referral and authorization process
Track referrals through required administrative steps
Assist with gathering information needed for prior authorization submissions
Track pending prior authorizations
Follow up on authorization requests and outstanding documentation
Monitor authorization effective and expiration dates
Assist with recertification tracking and administrative processing
Identify missing documentation or information
Communicate outstanding items to the appropriate team members
Help prevent interruptions in service related to authorization issues
Maintain accurate notes and status updates
Operations & Workflow Support

Support team members with billing-related and operational workflow questions
Assist with resolving operational tickets and follow them through completion
Follow up on outstanding internal tasks
Support implementation and adoption of new software and systems
Assist with workflow development and process improvements
Help train and support staff when new processes or systems are introduced
Maintain organized tracking systems
Work closely with billing, scheduling, authorization, clinical, and operations teams
Identify workflow issues and recommend practical solutions
Help ensure information moves accurately and timely between departments
Software & Systems Support

Support implementation and ongoing use of healthcare software systems
Assist team members with workflow questions and basic system navigation
Identify system issues that may affect billing or operations
Coordinate unresolved issues with the appropriate internal or external support resources
Assist with testing new workflows and processes
Help maintain accurate information across systems
Experience with AlayaCare, Alora, Availity, EVV platforms, Monday.com, or similar healthcare systems is a plus.

QualificationsRequired

High school diploma or equivalent
At least 1 year of medical or healthcare billing experience
Working knowledge of healthcare claims and insurance billing processes
Experience with claim submission, rejections, denials, and payer follow-up
Basic knowledge of accounts receivable and payment processing
Familiarity with CPT, ICD-10, HCPCS codes, modifiers, and medical terminology
Experience working with electronic billing, EHR, or practice management systems
Understanding of HIPAA and patient confidentiality requirements
Strong attention to detail and accuracy
Strong organizational and time-management skills
Ability to manage multiple accounts, priorities, and deadlines
Strong written and verbal communication skills
Comfortable using Microsoft Office, Excel, email, and web-based systems
Ability to research billing problems and follow issues through resolution
Ability to work independently and collaboratively as part of a team
Preferred

2+ years of medical billing experience
Home health, home care, outpatient therapy, or other healthcare billing experience
Experience billing Medicare and Medicaid
Experience with managed care organizations and commercial insurance
Prior authorization and recertification experience
Experience with denial management and accounts receivable follow-up
Experience reviewing aging reports and billing reconciliation reports
EVV experience
Experience supporting multiple healthcare service lines
Medical billing certification such as CPB, CPC, CBCS, or similar is a plus but not required
Who We’re Looking For

We are looking for an A+ team player who:

Wants to grow with an established and rapidly expanding healthcare organization
Takes ownership of their responsibilities
Pays close attention to detail
Follows through until issues are resolved
Does not allow important tasks to fall through the cracks
Communicates proactively and professionally
Supports coworkers and contributes to a positive team environment
Looks for ways to improve processes
Is comfortable learning new technology and systems
Takes pride in accurate, organized, high-quality work
Values accountability, teamwork, respect, and continuous improvement
Benefits and What We Offer:

Eligible employees may receive benefits in accordance with company policies and applicable plan terms, including:

Competitive pay of $23.00–$27.00 per hour, based on experience
Full-time employment with an established and growing healthcare organization
Health benefits
Paid time off, subject to company policy and eligibility
Paid holidays, where applicable
Opportunities for professional growth and advancement
Training and professional development opportunities
Exposure to multiple areas of healthcare billing, revenue cycle, and operations
Opportunity to learn and work with multiple healthcare technology platforms
Supportive and collaborative team environment
Leadership that values initiative, accountability, and continuous improvement
Opportunity to contribute ideas and help improve company processes
Opportunity to grow alongside an organization experiencing rapid growth and expansion
An A+ work culture focused on respect, teamwork, accountability, excellence, and continuous improvement
A workplace where your work matters and your contributions are valued and appreciated
Pay: $24.00 - $26.00 per hour

Expected hours: 40.0 per week

Benefits:

401(k)
Dental insurance
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance
Work Location: In person