Billing & Credentialing Specialist (Work Location: Dousman, WI)
12 days ago
Dousman
Job Description Who We Are Lad Lake is a COA-accredited, nonprofit, independent organization serving youth and families across Wisconsin. With over 1,200 individuals benefiting from our trauma-informed programs, we are committed to guiding growth and promoting diversity, equity, and inclusion in all we do. Our mission is to help young people reach their potential and live responsibly. Behind every youth served is a team of dedicated professionals making it all possible—including our financial operations team. If you're detail-oriented, organized, and passionate about using your skills to support a greater cause, we’d love to meet you. What a Day in the Life of the Billing & Credentialing Specialist Looks Like: * Submit timely and accurate billing for Medicaid (ForwardHealth), private insurance, private pay clients, and contracted purchasers. * Track and manage claims, denials, appeals, and authorizations to ensure timely and maximum reimbursement. * Coordinate credentialing and re-credentialing of Lad Lake providers and programs with commercial insurance panels and Medicaid networks. * Maintain updated records in CAQH and payer portals; monitor licenses, insurance, and NPI data for ongoing compliance. * Reconcile payments, resolve discrepancies, and manage aging accounts receivable. * Collaborate with internal teams—including clinical, HR, and administration—to align documentation with billing and credentialing requirements. * Support audits, generate billing reports, and contribute to process improvements in billing and credentialing workflows. What You Bring to the Table: * Bachelor’s degree required (Accounting, Finance, or Healthcare Administration preferred). * 2–3 years of experience in healthcare billing, Medicaid claims, and accounts receivable management. * Familiarity with ForwardHealth, CAQH, payer portals, and provider credentialing. * Knowledge of CPT/ICD-10 coding, EOB interpretation, and prior authorization workflows. * Advanced proficiency in Excel and experience with billing/accounting systems (Sage 300 ERP a plus). * Strong attention to detail, organizational skills, and the ability to work independently. * Excellent communication skills and a mission-driven mindset. What We Bring to the Table: * Competitive Pay * Medical, Dental, Life Insurance, STD, LTD Benefits * Paid Time Off (up to 16 days annually to start) * Holiday Pay (up to 8 days) * Tuition reimbursement to support your career growth * 401k plan + profit sharing for your financial future * Casual dress code – wear what makes you comfortable! * Employee Assistance Program (EAP) for additional support * Federal Student Loan Forgiveness Employer * Professional development opportunities (we’ll pay you to learn!) * Longevity – We’re Wisconsin’s oldest youth service organization! * Career advancement – Many of our leaders started in entry-level roles and grew into leadership * A servant-leadership culture – Our leaders are here to support you so you can best support the mission Come join the Lad Lake family. Welcome home! (The actual base pay offered will consider internal equity and may vary based on education, experience, and job-related skills.)
151 North Main Street, 53118, Dousman
