Medical Billing Specialist

Options For Southern Oregon; Grants Pass (OR); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

Medical benefits

403(b) match

Paid time off

11 holidays

Job summary

Options for Southern Oregon in Grants Pass, OR, is seeking a Medical Billing Specialist to support our billing team with patient payments and insurance claims in behavioral health services. You will enter data into the EHR, manage claims, and work with insurance providers to resolve denials, ensuring timely, accurate reimbursements while maintaining confidentiality and meeting deadlines.

Strong organizational skills and knowledge of Oregon billing requirements are essential, with prior

Qualifications

• High school diploma or equivalent.
• Minimum of two years of medical billing experience.
• Knowledge of Oregon diagnosis requirements for billing preferred.
• Strong organizational skills and effective communication.
• Ability to work independently and flexibly under general supervision.
• Must pass state-required background and DMV checks.

Responsibilities

• Enter required billing data into the EHR.
• Create and generate reports to extract and verify billing data.
• Maintain detailed billing records, reports and files for billing department.
• Review and update patient charges, insurance data and demographic information in EHR.
• Assist clinicians with coding questions and resolves coding errors so claims can be generated correctly.
• Bills primary and secondary insurance carriers within timely filing guidelines and standards.
• Work with insurance representatives to solve denials or improper payments.
• Generate patient billing and ensure service approval status and fee agreement on file.
• Monitor reconciliation of third party insurance remittances and cash application.
• Verify clients’ private insurance coverage and determine services covered.
• Process month end close in the medical billing system and reconcile with accounting.
• Review and correct encounter data and Medicare billing exceptions.

Skills

Organizational skills

Time management

Communication skills

Education

High school diploma

Tools

EHR software

Job description

• Family medical, dental, long-term disability, 403(b) plan with 6% match, and more.
• Generous paid time off policy. (Annual accrual up to 208 hours - based on FTE status and available to use upon accrual). Plus, 11 paid holidays annually.

Hours: Monday-Friday 8am-5pm

Overview

The Medical Billing Specialist assists the billing department to accurately manage patient payments and insurance claims. The specialist submits claims and/or encounters for clinical services to insurance companies, and other payers, to ensure proper reimbursement. Adheres to claim submission deadlines, posts payments and enters data into the electronic health record (EHR). Utilizes medical terminology, CPT coding, ICD coding, and HCPCS in relation to behavioral health services to process claims through the EHR. Performs quality assurance reviews to ensure clean claims are submitted. Maintains working knowledge of the State of Oregon’s diagnosis requirements for billing behavioral health services under the Oregon Health Plan and the payment structure, to properly bill for services. Responsibilities are shared among individuals; one person will not have full responsibility for every duty.

Responsibilities

Enters required billing data into the EHR.

Creates and generates reports to extract and verify billing data.

Organizes, prepares, and maintains detailed billing records, reports and files for billing department.

Reviews and updates patient account charges, insurance data and demographic information in EHR software and researches missing or incorrect information that may affect claims submissions.

Assists clinicians with coding questions and ensures coding errors are resolved so claims can be generated correctly.

Bills primary and secondary insurance carriers within timely filing guidelines and departmental standards.

Works with insurance representatives to problem solve denials or improper payments. Ensures claims are paid appropriately.

Generates patient billing and ensures that these individuals have the necessary service approval status and fee agreement on file.

Monitors the reconciliation of third party insurance remittances and cash application.

Verifies clients’ private insurance coverage and works closely with insurance providers to determine type of services covered.

Processes month end close in the medical billing system and reconciles with agency’s general accounting system.

Reviews and corrects encounter data and Medicare billing exceptions.

Maintains confidentiality, punctuality, attendance, and ethical conduct at all times.

Qualifications

High school diploma or equivalent.

Minimum of two (2) years of experience performing medical billing or a combination of related medical office experience and accounts receivable.

Working knowledge of the State of Oregon’s diagnosis requirements for billing preferred.

Practice strong organizational skills, effective use of time and excellent communication.

Use effective customer relations skills, including the ability to work with diverse people in a stressful environment, displaying an understanding of group dynamics and dealing with stress effectively.

Possess business experience sufficient to meet the demands of the position, including proficiency with a variety of software applications.

Must pass state-required background and DMV checks; Candidate must be able to work independently and flexibly, under general supervision.

Options for Southern Oregon provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.