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/Abilitie s 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.