Billing Specialist II

Rocking Horse Community Health Center•Springfield, OH

7d•Hybrid

About The Position

Rocking Horse Community Health Center (RHCHC), a Federally Qualified Health Center serving vulnerable populations, is seeking a Medical Billing Specialist II. The role manages complex billing functions, including claim resolution, denial management, and payer-specific requirements. The specialist independently analyzes and resolves billing issues while supporting cash flow and compliance. The position is based at the Springfield, Ohio South Limestone location and may be hybrid remote. It is a full-time, non-exempt hourly position. Productivity, quality, and turnaround-time expectations apply, and the role may handle escalated and high-priority accounts. The work is performed in support of RHCHC’s mission, vision, and values. The employee is expected to understand the role of FQHCs as a safety net for all people regardless of ability to pay, value patient-centered care in a medical home, and support quality, comprehensive services delivered through a team approach. The position requires strict confidentiality and compliance with privacy policies, including sharing only the minimum necessary patient or employee information. The employee must be receptive to change and improvement, and consistently follow instructions and established policies and procedures.

Requirements

High school diploma or equivalent (GED) required.
Strong knowledge of insurance guidelines, the claim lifecycle, and reimbursement processes.
Proficiency with CPT, ICD-10, and HCPCS coding systems.
Experience with EHR/EMR systems and billing software.
Ability to work independently and manage a high-volume workload.
Strong analytical, problem-solving, and organizational skills.
Excellent communication skills for interactions with payers and internal colleagues.
Ability to read and comprehend simple instructions, correspondence, and memos; write simple correspondence; and present information effectively in one-on-one and small-group settings.
Ability to perform basic arithmetic, calculate rates, ratios, and percentages, and interpret bar graphs.
Ability to apply common sense to written, oral, or diagrammed instructions and solve problems involving several concrete variables in standardized situations.
Current Ohio driver’s license and acceptable driving record.
Commitment to confidentiality and understanding of privacy policies and procedures.
Ability to adapt to change and new ideas, and consistently follow verbal and written instructions and established policies and procedures.
Ability to meet the stated physical demands, including occasional lifting or moving of up to 25 pounds.

Nice To Haves

Associate degree or certification in medical billing or coding.
Four to six years of experience in medical billing, revenue cycle, or healthcare finance.
Experience with denial management and appeals processes.
Familiarity with Medicare, Medicaid, and commercial insurance.
Ability to identify trends and suggest process improvements.
Knowledge of clearinghouses and electronic claim submission systems.
Basic reporting and Excel skills for tracking and analysis.

Responsibilities

Review, prepare, and submit complex medical claims.
Conduct detailed account follow-up with insurance companies to secure proper reimbursement.
Identify causes of claim denials and support denial management and resolution.
Post payments and adjustments.
Maintain detailed, compliant notes for all billing activity.
Independently analyze and resolve billing issues while supporting cash flow and compliance.
Manage escalated and high-priority accounts as needed.
Follow confidentiality and privacy policies, sharing only the minimum information necessary.
Carry out duties in accordance with the organization’s mission, vision, values, policies, and procedures.