Medical Claims Specialist

Join Our Team at Dunn County

At Dunn County, we're more than just a local government – we're a community of dedicated professionals united by our core values and committed to serving our residents. Our culture is built on five fundamental principles that guide everything we do:

Our Core Values in Action

• Dedication - We demonstrate unwavering commitment to those we serve, ensuring that every decision and action is focused on enhancing the quality of life for Dunn County residents.
• Professionalism - Excellence is our standard. We maintain the highest levels of competence while fostering an environment of courtesy and respect in all our interactions and responsibilities.
• Ethics - Integrity is non-negotiable. We pride ourselves on consistently acting with honesty and transparency, building trust through ethical decision-making in every aspect of our public service.
• Betterment - Innovation drives us forward. We're committed to continuous improvement, constantly seeking ways to enhance our services and the value we deliver to our community.
• Collaboration - Together we achieve more. We foster an inclusive environment where diverse perspectives are valued, and teamwork is essential to achieving our shared goals.

Job Summary

Primary Responsibilities

The following duties are primarily performed and are essential for this position.  Employees are expected to be able to perform each of these job duties satisfactorily and successfully to be qualified for the position.  Other duties may be required and assigned.

• Performs specialized accounting and bookkeeping support activities for the department.
• Manages the assignment of Accounts Receivable by recording payments, maintaining receipt spreadsheets, and downloading remits for deposits.
• Responds professionally to customer billing inquiries and ability to pay issues.
• Performs charge entry, creates invoices and statements. Bills insurance companies using UB-04 and 1500 forms. Mails statements to consumers/ residents.
• Analyzes consolidated billing invoices for payment and charge entry. Verifies and reprices invoices per department procedures and CMS guidelines. Codes deposits for general ledger posting, enters invoices for payment for general ledger posting.
• Remains aware of current billing/coding guidelines and informed of changes to current rules; 
• Makes recommendations for process change and creates training documents for reference. 
• Creates resident/consumer accounts with correct payers; verifies correct census and insurance coverage, monitors for discrepancies and fixes errors if found.
• Manages prior authorization process.
• Manages subsidiary ledgers in program-based software. Manages changes to the charge master.  
• Acts as Super User, trouble shoots, recommends updates to financial modules. 
• Works with Manager to ensure electronic transactions are accurately posted. 
• Requests write-offs and initiates payment plans for residents /consumers. 
• Reconciles month-end revenues; creates journal entries that are needed to balance cash receipts; uploads journal entries created by Accounting Manager,
• Provides Accounting Managers with revenue reports.
• Responds to customer payment and billing inquiries.
• Communicates by writing and telephone with appropriate parties (i.e. Power of Attorney, Guardian) and ensures proper release of information is documented. 
• Reviews all providers contact notes completed by professional staff before submission to payer sources for all Behavioral Health and Birth to Three Program providers to ensure correct coding and documentation appear in the note as required by State and/or Federal billing and documentation guidelines for the service provided.  
• Initiates and assists with revenue contract development.
• Completes group, facility and individual provider credentialing with all payers.
• Coordinates with Medical Biller position to ensure tasks are completed timely.
• Performs all related duties as assigned.

Minimum Qualifications

EDUCATION AND/OR EXPERIENCE REQUIREMENTS

• Associate’s Degree in Accounting, Finance, or other related field. 
• Minimum of two (2) years previous medical billing or finance experience.

• Valid driver’s license or the ability to travel between work locations. 
• Prior to hire, a background check including criminal record history will be conducted.  Information from the background check will not necessarily preclude employment but will be considered in determining the applicant’s suitability and competence to perform in the position.

• Knowledge of general office procedures and practices.
• Experience with general office productivity software (i.e. Microsoft Office Suite, Google Suite, relational database programs, etc.), general office equipment and computers.
• Knowledge of billing, collection, reimbursement and reconciling practices, requirements and rules. 
• Skill in implementing, monitoring and maintaining accounting records, accounts payable, accounts receivables and general ledgers.
• Ability to apply department and/or county specific procedures, policies, and operational routines pertaining to assigned areas of responsibility.
• Ability to implement billing procedures and processes of the department.
• Ability to assist managers in compiling and preparing budget information and assisting in tracking and monitoring approved budgets.
• Ability to prepare required agency financial reports and documents required by state, federal or local funding agencies and sources.

• Ability to establish and maintain effective and professional working relationships.
• Ability to manage time effectively, manage multiple projects, and complete work within established deadlines.
• Ability to work the allocated hours of the position.

• Ability to communicate effectively with other members of the staff, supervisor, and customers. 
• Ability to communicate clearly and concisely in both written and verbal form. 

• English skills (oral, written and comprehension) sufficient to effectively communicate with all internal and external customers.

• Ability to understand and effectively carry out verbal and written instructions.
• Must have ability to work accurately with attention to detail.
• Ability to prepare and maintain accurate and concise records and reports.
• Adheres to HIPAA privacy regulations.

• Ability to make arithmetic computations using whole numbers, fractions and decimals.
• Ability to compute rates, ratios and percentages.
• Ability to understand and apply governmental accounting practices in maintenance of financial records.

Physical and Work Environment

The physical and work environment characteristics described in this description are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions or as otherwise required by law.  Employees needing reasonable accommodation should discuss the request with the employee’s supervisor or Human Resources.  
 
PHYSICAL REQUIREMENTS

• Physical effort will typically require infrequent exertion of objects weighing up to 10 pounds.
• Continuous speaking, hearing and using hands dexterously, sitting, standing, walking and reaching with hands and arms.
• Work has standard vision requirements.
• The physical and environmental hazards and risks associated with the job can be characterized as minimal.

• Work is generally in a moderately noisy location (e.g. business office, moderate traffic).

Equal Opportunity Employer

Dunn County is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

By applying for this position, you acknowledge that you have read our job posting in its entirety and meet the basic requirements outlined above. Dunn County looks forward to reviewing your application.