Medical Billing Specialist

ONE Health Ohio•Youngstown, OH

About The Position

ONE Health Ohio is a Federally Qualified Health Center that provides care regardless of patients’ ability to pay. The Medical Billing Specialist supports the organization’s financial health by managing daily revenue cycle workflows, including billing, collections, payment processing, and account follow-up. The employee may be required to work at any ONE Health Ohio location deemed necessary by the organization.

Requirements

Certified Biller certification is required.
Understanding of ICD-10, CPT, and HCPCS coding structures.
Ability to maintain confidentiality and accurate records.
Ability to enter and maintain data in various company software programs.
Knowledge of company policies and procedures and modern office equipment, troubleshooting, practices, and procedures.
Planning and organizational skills; ability to identify problems and propose feasible solutions.
Proficiency in Microsoft Office, including Word, Excel, Outlook, and Publisher.
Interpersonal and human-relations skills, a positive and professional attitude, and proficient telephone skills.
Physical ability to sit for extended periods, reach in any direction, use finger dexterity to manipulate objects such as a keyboard, communicate verbally, see and hear within normal parameters, and move about.

Nice To Haves

At least 2 years of medical billing experience (preferred).
Certified Coder certification (preferred).

Responsibilities

Prepare, review, and submit clean claims to Medicaid, Medicare, commercial insurance plans, and patient accounts using the sliding fee scale.
Ensure coded procedures comply with applicable regulations and organizational guidelines.
Track, investigate, and appeal denied or rejected claims; identify denial patterns, resolve submission errors, and promptly resubmit corrected claims.
Collaborate with clinical staff to resolve documentation discrepancies and assist patients with complex billing inquiries or sliding fee updates.
Follow up on and report the status of delinquent accounts.
Review accounts for possible assignment, make recommendations to the Director of Billing and Reimbursement, and prepare information for the collection agency.
Perform collection actions, including contacting patients by phone and correcting and resubmitting claims to third-party payers.
Process insurance payments and prepare a daily deposit.
Work with an administrator to train providers in coding and the EMR system.