Medical Billing Specialist

Finance Dayton, Ohio Columbus, Ohio Columbus, Ohio _, Ohio


Description


ESSENTIAL JOB FUNCTIONS: 

Essential functions of the job include, but are not limited to, data entry, typing, filing, sorting, utilizing a computer for data entry, conducting research, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets, and Medical Billing.  Communicating with others is an essential job function. 

 

POSITION SUMMARY: 

The Medical Billing Specialist reports to the Revenue Cycle Manager, under the direction of the Director of Revenue Cycle Operations, and is responsible for various business office tasks to ensure efficient billing, follow up, payment posting, and patient statement activities in order to maximize revenue.    

SALARY: Biller, uncertified:  $ 42,500- $53,100 
              

MAJOR AREAS OF RESPONSIBILITY: 

  • Review billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures. 
  • Prepare and submit clean claims to various insurance companies to include both paper and electronic. 
  • Extensive insurance follow-up and working knowledge of the appeals resolution process is required. 
  • Responsible for contacting insurance companies and navigating insurance websites in order to secure and expedite payments. 
  • Post insurance payments in a timely and accurate manner. 
  • Answer billing inquiries from patients, clerical staff and insurance companies. 
  • Identify and resolve patient billing complaints. 
  • Prepare, review, and send patient statements for Medical Center. 
  • Reconcile daily receivables for the Medical Center. 
  • Evaluate patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts. 
  • Perform various collection actions including contacting patients by phone correcting and resubmitting claims to third party payers. 
  • Participate in educational activities and attends monthly staff meetings. 
  • Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations. 
  • Perform other duties for Medical Center. 

EDUCATION/LICENSURE: 

  • High school diploma, Associate’s preferred 
  • Medical billing certification preferred. 
  • AAPC or other appropriate Professional Coding Certification preferred  
  • CPC, CPA, or relevant certification. 

 

KNOWLEDGE, SKILLS, ABILITIES AND OTHER QUALIFICATIONS: 

  • High school diploma
  • Medical billing certificate preferred. 
  • Professional Coding or Auditing Certification preferred CPC, CPA, or relevant certification.  
  • Financial management, payment processing, and/or accounting experience, and/or formal training or certification preferred 
  • Three to five years of medical billing experience in a medical office setting or equivalent combination of training and experience required. 
  • Must have strong knowledge of CPT and ICD-10 codes and basic medical terminology skills. 
  • Experience with EMR (Electronic Medical Record) and medical billing software preferred.  
  • Epic experience is preferred.  
  • Knowledge of third-party operating procedures and practices, with the ability to read and process EOB’s. 
  • Proven record of accomplishment of exceeding goals; evidence of the ability of consistently make good decisions through a combination of analysis, experience and judgment; abilities in problem solving, project management and creative resourcefulness. 
  • Understanding of documentation to Coding for Evaluations of revenue processes 
  • Strong understanding of Coordination of billing with health insurances, Medicare, Medicaid, (Ohio),  
  • FQHC or communication health systems billing experience a plus 
  • Dental, Behavioral Health and Pharmacy billing a plus 
  • Must be proficient in use of Microsoft Office (Access, Excel, Word and Outlook). 
  • Ability to work in a fast-paced, deadline-driven, changing environment. 
  • Manages multiple demands, work well under pressure and work independently. 
  • Highly organized multi-tasker who sets individual and team priorities and effectively monitors progress towards achievement. 
  • Must possess sound business judgment, exercise professional conduct, understand and follow business ethics and standards, and maintain a high level of confidentiality in all duties. 
  • Must possess outstanding verbal and written communication skills along with strong interpersonal and organizational abilities. 
  • Ability to function effectively as a member of a team, and a willingness to participate in activities and assignments that will benefit other members of the team or will contribute to the accomplishment of team objectives. 
  • Must be able to establish and maintain professional, productive and courteous interactions with employees that promote positive teamwork, as well as with constituents of the organization. This encompasses going beyond giving and receiving instructions and includes but is not limited to (a) performing work activities requiring interacting or speaking with others, and (b) responding appropriately to constructive feedback or suggestions for improvement from a supervisor. 
  • Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, and a demonstrated competence in working with persons of color, and gay/lesbian/bisexual/transgender community.  
  • Professional appearance and demeanor. 

 

OTHER INFORMATION: 

Background and reference checks will be conducted.  Hours may vary, including working some evenings and weekends based on workload.  Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment.  Completing the application does not guarantee employment.  In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered.  EOE/AA