Medical Billing & Claims Specialist — Revenue Integrity

Blanchard Valley Health System; Findlay (OH); On-site; USD 42,000 - 66,000; Full time

Job summary

Blanchard Valley Health System in Findlay, OH seeks a Claims Specialist to manage all medical claims from pre-billing to follow-up, ensuring clean, timely reimbursement. You will verify information, gather missing data, and support accurate billing.

Responsibilities include auditing demographics and eligibility, submitting manual claims when needed, monitoring error reports, educating staff, and identifying payment trends to improve processes. Strong HIPAA knowledge and Excel skills required.

Qualifications

• High school diploma or GED required.
• CPFSS certification due within 12 months of hire.
• Familiarity with medical terminology and HIPAA requirements.
• Proficient with Microsoft Excel and other MS Office programs.
• Strong time management and organizational skills.
• Ability to work independently or with others.
• Experience with revenue cycle processes or medical billing is a plus.

Responsibilities

• Ensure compliant claims submission with HIPAA and state regulations; document all account activity.
• Process daily electronic billing through the organization’s system to achieve clean first-time reimbursement.
• Correct claims issues before submission; verify demographics, eligibility, and payer requirements.
• Educate other staff when documentation is insufficient for billing.
• Prepare and submit manual claims for payers not accepting electronic submissions.
• Monitor error reports to identify trends and opportunities for process improvements.
• Track outstanding holds and escalate delays; communicate findings to supervisor.
• Adhere to best practices in billing, follow-up, and customer service; report compliance concerns.
• Identify high-risk accounts and prioritize follow-up to expedite payment.
• Investigate over/underpayments and coordinate with payers to rectify.
• Proactively recognize issues to prevent audits and share findings with leadership.
• Attend staff meetings and training to maintain and upgrade certifications.

Skills

Excel proficiency

Time management

Organizational skills

Problem solving

HIPAA familiarity

Independent / collaborative work

Medical terminology

Education

Associate’s degree

CPFC CPCS certification

2–3 years medical billing experience

Job description

Blanchard Valley Health System in Findlay, OH seeks a Claims Specialist to manage all medical claims from pre-billing to follow-up, ensuring clean, timely reimbursement. You will verify information, gather missing data, and support accurate billing.

Responsibilities include auditing demographics and eligibility, submitting manual claims when needed, monitoring error reports, educating staff, and identifying payment trends to improve processes. Strong HIPAA knowledge and Excel skills required.