Medical Billing Specialist I or II

State of Oklahoma • OK

84d • $53,600

About The Position

The Medical Billing Specialist is responsible for the outpatient billing cycle for client services rendered at the county health departments. Reviews and submits medical claims to third-party payers. Researches and determines appropriate actions for correcting rejected and denied medical claims. Reconciles claims and posts any adjustments, transfers, and/or payments to patient accounts. Assists in identifying medical billing issues that require further attention. Level II: At this level of work, may assist in training county health department staff on various aspects of medical billing, and is involved in quality improvement.

Requirements

• Level I: Two (2) or more years of experience in a medical or behavioral health office or an associate’s degree in a related field or equivalent combination of education and experience.
• Substituting six semester hours completed at an accredited college or university for each six months of the required experience or the completion of a vocational training course in medical billing.
• Level II: Four or more years of experience in medical or behavioral health office or a bachelor’s degree in a related field and one year of experience or equivalent combination of education and experience.
• Substituting six semester hours completed at an accredited college or university for each six months of the required experience or the completion of a vocational training course in medical billing.

Nice To Haves

• Professional Medical Billing certification

Responsibilities

• Review/scrub claims prior to submission to improve clean claim submission rate.
• Review rejected claims for errors; determine steps to resolve the errors; and take corrective action for claims resubmission.
• Review denied claims for denial reasons; determine steps necessary for successful claims submission based on those reasons according to payer contracts and requirements; and take corrective action to resubmit claims for maximum reimbursement.
• Provide centralized facilitation and monitoring of requests for prior authorizations for services when required by payer contracts.
• Enter payment and non-payment data from remittance advice (RA) to reconcile claims in the billing system, which includes identifying and documenting the appropriate adjustment or non-payment reason; file paper RAs.
• Identify and troubleshoot anomalies and possible errors in the claims process and communicate verbally and in writing to supervisor for further analysis.
• Communicate and follow up with county health department staff to assist in correcting claims at the client level.
• Participates in audits and assists with internal quality improvement initiatives related to billing and coding.
• Respond to inquiries in the Medical Billing inbox and inquiries that arise via phone in a professional and timely manner.
• Attend payer trainings, updates, and webinars and review any guidance to maintain and improve medical billing knowledge and skills.
• May assist with provider credentialing and access to provider portals.
• Level II: May be involved in developing training materials and delivering training to OSDH staff.

Benefits

• Generous state paid benefit allowance to help cover insurance premiums.
• A wide choice of insurance plans with no pre-existing condition exclusions or limitations.
• Flexible spending accounts for health care expenses and/or dependent care.
• Retirement Savings Plan with a generous match.
• 15 days of vacation and 15 days of sick leave the first year for full time employees.
• 11 paid holidays a year.
• Student Loan repayment options & tuition reimbursement.
• Employee discounts with a variety of companies and vendors.
• Longevity Bonus for years of service.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree