Medical Billing Specialist ; Ohio-Based

ZEPF CENTER•Toledo, OH

About The Position

Zepf Center is seeking a full-time Medical Billing Specialist to perform billing and collection activities for open receivables and ensure accurate, timely posting in the billing system. The role handles patient and insurance information, claims, payments, denials, and related inquiries, and provides backup support to other Billing Department staff. The position is responsible for maximizing payment from assigned payer sources. Work is varied and requires close attention to detail, mathematical and analytical ability, and problem-solving skills.

Requirements

High school diploma or equivalent.
At least two years of experience in medical billing, payment posting, denial management, and collections in a medical office setting.
Extensive knowledge of and experience with billing systems, insurance, BWC, Medicare, Medicaid, electronic claims, data entry, and accounts receivable.
Computer experience and proficiency in Excel, Word, and Outlook.
Strong numeric and computer skills.
Attention to detail, strong organizational and problem-solving skills, and self-initiated follow-up.
Professional conduct in relationships with staff, clients, other agencies, and the public, and adherence to agency and professional codes of ethics.

Nice To Haves

Associate degree in medical billing.

Responsibilities

Review and update patient insurance information and coordination-of-benefits order, and reallocate balances as needed to ensure billing to the correct coverage plan.
Prepare 837 EDI claim files and upload or forward them electronically for payment.
Retrieve 835 remittance files and upload them into the billing system.
Post payments and adjustments, manually and electronically, to individual client ledgers.
Review payment and adjustment amounts for accuracy during posting and note discrepancies.
Reconcile EOBs, deposits, and postings in detail to ensure postings and payments match accounts receivable ledgers.
Work denials, rejections, underpayments, and overpayments during and after posting, and follow up to ensure accurate and timely payment.
Submit and resubmit claims and corrections through the EHR, payer portal, or clearinghouse, and monitor and follow up on submissions.
Prepare and send documents needed for payment, refunds, or plan updates.
Monitor and research unpaid, underpaid, and overpaid accounts receivable; resolve denials, resubmit claims, and follow up to prevent aging receivables.
Communicate claims issues to contacts at assigned payers and involve management as appropriate.
Review and verify client insurance eligibility as needed and update the billing system with accurate dates and status.
Respond to patient and staff phone calls, investigate inquiries, and respond accordingly; involve management when necessary.
Provide backup and support to other fiscal and accounts receivable staff.
Carry out agency policies and procedures; participate as applicable in community work, staff development, agency-wide projects, committees, teams, and meetings, and perform other requested duties.