Medical Billing Specialist

ONE Health Ohio•Youngstown, OH

About The Position

ONE Health Ohio is a Federally Qualified Health Center that provides care to everyone in its communities, regardless of ability to pay. Its mission-driven team works to make high-quality care accessible to all. The Medical Billing Specialist supports the organization’s financial health by managing daily revenue cycle workflows. The role may require working at any ONE Health Ohio location deemed necessary by the organization. This job description is not all-inclusive, and the employee may perform other related duties as negotiated to meet ongoing organizational needs.

Requirements

  • Certified Biller certification is required.
  • Understanding of ICD-10, CPT, and HCPCS coding structures.
  • Ability to maintain confidentiality and accurate records.
  • Professional attitude, planning and organizational skills, and interpersonal and human relations skills.
  • Proficiency in Microsoft Office, including Word, Excel, Outlook, and Publisher.
  • Ability to identify problems and propose feasible solutions.
  • Ability to enter and maintain data in company software programs.
  • Knowledge of company policies and procedures and modern office equipment, troubleshooting, practices, and procedures.
  • Proficient telephone skills.

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 sliding fee scale patient accounts.
  • 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 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.

Benefits

  • Paid time off 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.
  • No nights or weekends.
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