About this role
ONE Health Ohio is a Federally Qualified Health Center providing care to everyone in our communities, regardless of their ability to pay. Our mission-driven team works together to make high-quality care accessible to all.
The Medical Billing Specialist ensures the financial health of our organization by managing daily revenue cycle workflows.
Essential Job Functions
- Routine medical billing procedures: Prepare, review and submits clean claims to Medicaid, Medicare, commercial insurance plans, and our sliding fee scale patient accounts.
- Ensure all coded procedures match compliance and organizational guidelines.
- Track, investigate and appeal denied or rejected claims. Identify denial patterns, resolve submission errors, and resubmit corrected claims in a timely manner.
- Collaborate with clinical staff to resolve documentation discrepancies and assist patients with complex billing inquires or sliding fee updates.
- Follows and reports the status of delinquent accounts.
- Reviews accounts for possible assignment and make recommendations to the Director of Billing and Reimbursement, also prepares information for the collection agency
- Performs various collection actions including contacting patients by phone, correcting, and resubmitting claims to third-party payers.
- Processes payments from insurance companies and prepares a daily deposit.
- Ensures accurate billing and coding as per regulations.
- Works with administrator in training providers in coding and EMR system.
Benefits
- No nights or weekends!
- PTO and Paid Holidays
- Optional Medical, dental and vision plans
- 401(k) retirement plan
- Company-paid life insurance with/AD&D benefit
- Company-paid long-term disability plan
- Optional life insurance and short-term disability plan
- Optional Critical Illness Plan
- Optional Accident Insurance Plan
Other Skills/Abilities
- Ability to maintain confidentiality
- Present a positive and professional attitude
- Planning and organizational skills
- Proficient in Microsoft Office (Word, Excel, Outlook, Publisher)
- Ability to identify problems and to propose feasible solutions
- Ability to maintain accurate records
- Ability to enter and maintain data in various company software programs
- Knowledge of company's policies and procedures
- Knowledge of modern office equipment, troubleshooting, practices, and procedures
- Interpersonal/human relations skills
- Proficient telephone skills
Education and Experience
- Minimum of 2 years experience medical billing (Preferred)
- Certified Biller (Required)
- Certified Coder (Preferred)
- Understanding of icd-10, CPT, and HCPCS coding structures.
Physical Requirements
- Sitting in a normal seated position for extended periods of time
- Reaching by extending hand(s) or arm(s) in any direction
- Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard
- Communication skills using the spoken word
- Ability to see within normal parameters
- Ability to hear within normal range
- Ability to move about
NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization. Employee is able to work at any OHO locations deemed necessary by OHO.