Medical Billing Spec

OSS Health; United States; On-site; USD 42,000 - 58,000; Full time

Benefits offered by this job

Competitive wages

Medical, Dental, Vision on day 1

Disability & Life Insurance within 90d

Group Life Insurance & Short/Long-Term

Paid Time Off

401(k) with profit sharing

Job summary

OSS Health is seeking a Medical Billing Specialist to join the Revenue Cycle team. You will ensure proper reimbursement by reviewing payer requirements, correcting errors, and supporting Patient Financial Services and patients with billing inquiries.

The role requires attention to detail, familiarity with Medicare/Medicaid and commercial plans, and strong organizational skills to manage denials and resubmissions.

Qualifications

• At least 2 years’ experience in medical insurance billing for a hospital, clinic, or doctor’s office.
• Must be detail oriented with strong organizational and communication skills.
• Understanding of Medicare, Medicaid, and Commercial coverage and claim requirements.

Responsibilities

• Verify claim accuracy including demographics, coverage, coding, modifiers, and documentation.
• Correct and resubmit denied or rejected claims promptly.
• Communicate with payers to resolve delays, denials, and underpayments.
• Document all account activity in billing systems per standards.
• Review EOBs to determine root causes and initiate corrections or appeals.
• Assist patients and patient financial services with billing questions.

Skills

Medical billing

Payer communications

Detail oriented

Organization

Education

High school diploma

Associate degree or Medical Billing certificate preferred

Tools

Medent

CPSI

SSI software

Job description

At OSS Health, our mission is to continually strive to be the healthcare leader in quality,innovationand value. We make every effort to understand and exceed the expectations and needs of our patients.We are committed to providing an environment that is safe, respectful, and dignifiedat all times.

Joining OSS Health means joining a culture of excellence and teamwork, with a strong focus on employee development and community support. OSS Health offersa great workenvironment, professional development opportunities, meaningful careers, and competitive compensation.

JOB SUMMARY:

TheMedical Billing Specialistis a key member of the Revenue Cycle team responsible forensuring thatthe organization receives proper reimbursement by reviewing payer requirements, correctionoferrors and supporting Patient Financial Services and the patients with billing inquiries.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Verify claim accuracy, including demographics, insurance coverage, coding, modifiers and required documentation.
• Correct and resubmit rejected or denied claims promptly
• Communicate with payers to resolve delays,denialsand underpayments.
• Document all account activity inbilling systems perdepartmentstandards.
• Review denial codes and explanation of benefits (EOBs) todetermineroot causes
• Initiate corrections,appealsor re-billing procedures as needed.
• Work with coding,clinicalandfront-endteams to prevent recurring errors.
• Assistpatients and patient financial services with billing questions, statements,and balance questions.
• Ensure billing practicescomply withpayer policies, CMSregulationsand organizational standards.
• Maintain thorough,accuraterecords of billing actions and follow-ups.
• Support audits and quality reviews.
• Escalatesdifficult or recurringissuestothe Revenue Cycle Manager toidentifya trend, resolve the isolated issue orrendercorrection to the billing process.
• Demonstratesgood judgment in safeguarding OSS information to include confidentiality of all medical and patient information.
• Resolution of any Coordination of Benefits, Self-Pay Adjustments or Bundled Pricing
• Followsall policies and procedures ofOSS.
• Otherduties as assigned.

EDUCATION:

• High school diploma or equivalent isrequired;Associate Degreeor Accredited Certificate from a Medical Billing program is preferred.

EXPERIENCE AND QUALIFICATIONS:

• At least 2 years’ experience in medical insurance billing for a hospital, clinic, or doctor’s office.
• Must be detail oriented andpossessexcellent organizational skills, timemanagementand communication skills
• Must have a working understanding of hospital and/or physician claim requirements for Medicare, Medicaid, Commercial Healthcare Insurance.
• Must be able to prioritize duties and communicate directly with insurance companies, patients, physicians, co-workersand vendors.
• Must be a team player and willing to work with all staff to get the overall job accomplished.Mustmaintaina cooperative working relationship with alland handledifficult situationstactfully.
• Experience withMedent,CPSIand SSIsoftwarepreferred.
• Must have the ability to review and understand written materialpertaining toorthopaedicsand general healthcare, including terminology and reimbursement issues.

BENEFITS INCLUDE:

• Competitive Wages
• Medical, Dental, Vision available on the first day of employment
• Disability, and Life Insurance within90 days
• Company-Paid Group Life Insurance, Short-Term Disability & Long-Term Disability
• Paid Time Off (PTO)
• 401(k) plan andprofit sharing

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.