Insurance Billing Specialist

St. Croix Health is looking for a full‑time (1.0 FTE) Insurance Billing Specialist to join our team. This position will work Monday through Friday during day hours. The role will be 100% onsite at our St. Croix Falls, WI location during the training period (approximately the first 1–3 months). Once training is complete, the possibility to move to a hybrid schedule exists, but hybrid employees are required to live within a commutable distance from our primary location and attend on‑site workdays, meetings, and trainings.

1.
Process insurance claims

• Ensure appropriate processing of claims.
• Verify patient eligibility or coverage as needed for all payors.
• Knowledge of UB and 1500 claim elements impacting processing.
• Accountable for accurate and timely claim submissions in accordance with A/R goals.

2.
Follow up on all unpaid claims and/or underpaid encounters

• Work billing queues in a timely manner.
• Accountable for account aging and incoming correspondence, providing timely and appropriate follow‑up.

3.
Follow up on denials

• Analyze, research, and navigate payer‑specific coverage and reimbursement policies.
• Analyze reason for denial and work toward appropriate resolution.
• Knowledge of appeal process by payer.

4.
Assist patients with billing questions and concerns

• Knowledge of all insurance explanation of benefits.
• Ability to work with insurance providers and member services to ensure patient understanding and claim processing.

• High school graduate required.
• Associate’s degree in Medical Administration or related field preferred.
• If no degree, healthcare experience required.

• 1–2 years of billing or charge‑entry experience in healthcare is preferred.
• Experience with electronic medical records and billing systems.
• Experience in a healthcare business office.

• Basic computer skills, including but not limited to Microsoft Office products.
• Ability to assess and prioritize workload.
• Excellent interpersonal, verbal, and written communication skills.
• Adaptability to change.
• Self‑motivated, takes ownership in expectations/goals, and sees them through in a timely manner, seeking supervision appropriately.

• Knowledge of insurance billing both UB04/837I and HCFA 1500/837P claims processing & insurance terminology.
• Understanding of Critical Access and Rural Health billing.
• Knowledge of Medicare, Medicaid, HMO, and private payer billing rules and regulations.
• Ability to interpret and understand payer remittance advices.

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.

St. Croix Health is an Equal Opportunity Employer. We will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact us at HR or 800‑828‑3627.

St. Health has been a healing force in the St. Croix Valley for over 103 years. We are a purpose‑driven organization with a dedicated team committed to serving our patients and communities throughout the St. Croix Valley. This commitment is rooted in our mission, vision and values.

We help people live healthier, happier, and longer lives.

To transform from quality sick care to quality well care that is sustainable and affordable.

People Centered, Trust, Innovation, and Growth.

• Health, vision and dental insurance.
• 403(b) retirement program with employer match.
• Paid time off.
• Short‑term disability, long‑term disability and life insurance options.
• Education reimbursement.
• Employee assistance program (EAP).
• Wellbeing incentive program.
• Free parking.
• Employee prescription discount program.

St. Croix Health is a not‑for‑profit healthcare system located in St. Croix Falls, WI dedicated to helping people live healthier, happier, and longer lives. St. Croix Health offers the services of 80+ providers and 20 specialties with five community clinics in Minnesota and Wisconsin all supported by a critical access hospital on the main campus in St. Croix Falls, just an hour northeast of Minneapolis/St.

Paul. Nestled in the bluffs of the St. Croix River Valley, St. Croix Falls is the ideal place to work, live and play.