Medical Billing Specialist

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.