Medical Billing Specialist

ONE Health Ohio; Youngstown (OH); On-site; USD 38,000 - 58,000; Full time

Benefits offered by this job

PTO

Paid Holidays

Medical Insurance (optional)

Dental Insurance (optional)

Vision Insurance (optional)

Life Insurance

Long-term Disability

Short-term Disability

Critical Illness Plan

Accident Insurance

Job summary

ONE Health Ohio is a Federally Qualified Health Center dedicated to delivering high-quality care to all in our communities. The Medical Billing Specialist role ensures the financial health of our organization by managing daily revenue cycle workflows, submitting clean claims to Medicaid, Medicare, and plans, adjudicating denials, and collaborating with clinical staff to resolve documentation issues.

This position offers a no nights or weekends schedule, PTO and paid holidays, and optional

Qualifications

• Minimum of 2 years experience in medical billing (Preferred).
• Certified Coder (Preferred).
• Understanding of ICD-10, CPT, and HCPCS coding structures.

Responsibilities

• Prepare, review and submit clean claims to Medicaid, Medicare, commercial plans, and sliding fee scale patients.
• Ensure coded procedures match compliance and guidelines.
• Track, investigate and appeal denied or rejected claims; identify denial patterns and resubmit corrections.
• Collaborate with clinical staff to resolve documentation discrepancies and assist patients with billing inquiries or sliding fee updates.

Skills

Confidentiality

Professional attitude

Planning and organization

Problem solving

Data entry

Interpersonal skills

Education

Certified Coder (Preferred)

Tools

Microsoft Office

EMR system

Job description

ONE Health Ohio is a Federally Qualified Health Center providing care to everyone in our communities, regardless of their ability to pay. Our mission-driven team works together to make high-quality care accessible to all.

The Medical Billing Specialist ensures the financial health of our organization by managing daily revenue cycle workflows.

Essential Job Functions:

• Routine medical billing procedures: Prepare, review and submits clean claims to Medicaid, Medicare, commercial insurance plans, and our sliding fee scale patient accounts.
• Ensure all coded procedures match compliance and organizational guidelines.
• Track, investigate and appeal denied or rejected claims. Identify denial patterns, resolve submission errors, and resubmit corrected claims in a timely manner.
• Collaborate with clinical staff to resolve documentation discrepancies and assist patients with complex billing inquires or sliding fee updates.
• Follows and reports the status of delinquent accounts.
• Reviews accounts for possible assignment and make recommendations to the Director of Billing and Reimbursement, also prepares information for the collection agency
• Performs various collection actions including contacting patients by phone, correcting, and resubmitting claims to third-party payers.
• Processes payments from insurance companies and prepares a daily deposit.
• Ensures accurate billing and coding as per regulations.
• Works with administrator in training providers in coding and EMR system .
• No nights or weekends!
• PTO and Paid Holidays
• Optional Medical, dental and vision plans
• Company-paid life insurance with/AD&D benefit
• Company-paid long-term disability plan
• Optional life insurance and short-term disability plan
• Optional Critical Illness Plan
• Optional Accident Insurance Plan

Other Skills/Abilitie

s

• Ability to maintain confidentiality
• Present a positive and professional attitude
• Planning and organizational skills
• Proficient in Microsoft Office (Word, Excel, Outlook, Publisher)
• Ability to identify problems and to propose feasible solutionsAbility to maintain accurate records
• Ability to enter and maintain data in various company software programs
• Knowledge of company’s policies and procedures
• Knowledge of modern office equipment, troubleshooting, practices, and procedures
• Interpersonal/human relations skills

Education and Experience:

• Minimum of 2 years experience medical billing (Preferred)
• Certified Coder (Preferred)
• Understanding of icd-10, CPT, and HCPCS coding structures.

Physical Requirements

• Sitting in a normal seated position for extended periods of time
• Reaching by extending hand(s) or arm(s) in any direction
• Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard
• Communication skills using the spoken word
• Ability to see within normal parameters
• Ability to hear within normal range
• Ability to move about

NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization. Employee is able to work at any OHO locations deemed necessary by OHO.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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