Medical Billing Spec

OSS Health; York (York County); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Competitive Wages

Medical, Dental, Vision from day 1 of"

Disability and Life Insurance within 0

Company-Paid Group Life Insurance, SD&

Paid Time Off (PTO)

401(k) plan and profit sharing

Job summary

OSS Health in York County, PA is seeking a Medical Billing Specialist to ensure proper reimbursement by reviewing payer requirements, correcting errors, and supporting Patient Financial Services with billing questions.

The role emphasizes accuracy, timely resubmissions of denied claims, coordination with physicians and front-end staff, and adherence to CMS and payer policies. Experience with Medent, CPSI, SSI is preferred.

Qualifications

• High school diploma or equivalent required; Associate degree or certificate preferred.
• Minimum 2 years’ experience in medical insurance billing.
• Working knowledge of Medicare, Medicaid and commercial payer requirements.

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, denials and underpayments.
• Document all account activity in billing systems per department standards.
• Review denial codes and EOBs to determine root causes.
• Initiate corrections, appeals or re-billing procedures as needed.
• Work with coding, clinical and front-end teams to prevent recurring errors.
• Assist patients and Patient Financial Services with billing questions and balance inquiries.
• Ensure billing practices comply with payer policies and CMS regulations.
• Maintain thorough, accurate records of billing actions and follow-ups.
• Support audits and quality reviews.
• Escalate difficult or recurring issues to Revenue Cycle Manager to identify trends.

Skills

Detail oriented

Organizational skills

Time management

Communication skills

Team player

Prioritize duties

Education

High school diploma or equivalent

Associate degree or accredited certificate in medical billing

Tools

Medent

CPSI

SSI

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.