REIMBURSEMENT SPECIALIST

**We strongly encourage City of Racine residents to apply. We're committed to building a workforce that reflects and understands the community we serve.** **City residents will earn a 4% differential on top of the hourly pay range. Learn more and apply today!** **The City of Racine Public Health Department offers residents of the City of Racine and the Villages of Wind Point and Elmwood Park a wide range of services and information. The City of Racine Public Health Department is prepared to assist you with administrative, laboratory, and community and environmental health programs/services.** **POSITION PURPOSE:** Promotes and supports the Public Health Department by providing a variety of financial, clerical, administrative, and technical support services. Responsibilities include, but are not limited to, claims processing, financial reporting, as well as other special projects as assigned. Ensures the integrity of accounting information by recording, verifying, consolidating, and entering transactions. The Reimbursement Specialist reports to the Deputy Public Health Administrator and/or their designee. - Process and reconcile patient billing, claims, reimbursements, and revenue transactions while ensuring accuracy, compliance, and timely submission of claims. - Review, correct, and follow up on denied, rejected, disputed, or delayed claims; maintain reimbursement records and update client accounts accordingly. - Ensure compliance with HIPAA, Medicaid, legal, regulatory, and coding requirements; communicate coding updates and reimbursement changes to staff. - Manage provider portals, revalidations, medical records, account databases, and reporting systems to maintain accurate records and generate required reports. - Assist clients with intake, eligibility screening, licensing applications, referrals, and access to community and social service programs. - Prepare correspondence, contracts, reports, grant documentation, and other administrative records while maintaining confidentiality and data integrity. - Manage cash handling activities, including processing payments, reconciling transactions, preparing deposits, and maintaining financial records using MUNIS. - Monitor grants and contracts to ensure compliance with objectives, deliverables, reporting requirements, and funding guidelines. - Provide customer service by addressing inquiries, resolving concerns, processing requests, and explaining departmental procedures and regulations. - Support departmental operations through cross-training, staff training, quality assurance activities, emergency response collaboration, meeting participation, and maintaining reliable attendance. **Knowledge, Skills, and Abilities Required** - Working knowledge of community systems, ability to initiate referrals to community health care providers, social service, and advocacy agencies, and the ability to effectively refer clients as needed. - Knowledge of HIPAA compliance standards and all aspects of client privacy practices. - Knowledge/experience evaluating health trends and risk factors of target populations. - Ability to establish professional relationships with clients, peers, supervisors and community organization members. - Personal initiative combined with the ability to work independently and interdependently. - Substantial working knowledge of and experience with current Microsoft Office suite or newer (Word, Excel, Outlook, PowerPoint, and Publisher), desktop publishing, and the internet, combined with the ability to pass all required skills tests. - Previous experience working with large/specialized databases and preparing data for analysis. - Ability to analyze data and/or manipulate data in Microsoft Excel and/or applicable databases using established criteria to determine significance and assess outcomes. - Must be able to compare, count, measure, copy, compute, tabulate, and categorize data combined with the ability to pass all required skills tests. - Ability to effectively ac…