Medical Billing Specialist - Medicaid Managed Care

Health Partners; Lima (OH); On-site; USD 25,000 - 35,000; Full time

Benefits offered by this job

Starting pay $21.60/hour

Paid Time Off

Insurance (Medical, Dental, Vision, 1)

Paid Holidays

403b Retirement with match

Annual Reviews and Increases

Employee Assistance Program

Referral Bonus

Training Opportunities

Emerging Leaders Program

Job summary

Health Partners of Western Ohio is seeking a Medical Billing Specialist to prepare, submit, and follow up on insurance claims for Medicaid and other payers to support a clean revenue cycle.

You will review claims, verify coverage, handle patient inquiries, and maintain filing systems while staying current with CPT, CDT, and ICD-10 coding. A high school diploma is required; in-house training is provided.

Qualifications

• High School Degree or GED Required.
• Successful completion of in-house training.
• Experience with healthcare billing preferred.
• Understanding of different types of insurance (Medicaid, Medicare, Commercial, etc.).
• Computer experience and typing ability to operate practice management systems.
• Knowledge of basic medical terminology.

Responsibilities

• Reviews all claims before submission to insurance companies.
• Maintains file system for billed claim records and audit backups.
• Verifies coverage and follows up on submitted claims.
• Responds to inquiries from patients, providers, insurers regarding charges, remittances, and billing.
• Operates office equipment and processes payments; reconciles daily reports.

Skills

Insurance types

Typing speed

Medical terminology

Education

High School/GED

Tools

Practice management software

Job description

Medical Billing Specialist

Health Partners of Western Ohio is an independent, non-profit and community-directed organization. We serve low-income areas and places without access to care. We're led by a volunteer Board of Directors. Most of our board members are also patients. Our Mission is to eliminate gaps in health outcomes for all members of our community by providing access to quality, affordable, preventive and primary health care.

POSITION PURPOSE: With knowledge of FQHC billing requirements, the Accounts Receivable Specialist prepares, submits, and follows up on insurance claims to the state Medicaid program to support an efficient and effective revenue cycle.

ESSENTIAL FUNCTIONS AND BASIC DUTIES:

• Reviews all claims before submission to insurance companies.
• Maintains file system for billed claim records and back up for audit purposes.
• Verifies coverage and follows up on submitted claims.
• Requests corrected diagnosis for reimbursement purposes from providers.
• Responds knowledgeably to inquiries from patients, providers, insurance companies regarding covered charges, remittance advices, and billing questions.
• Works with Medicaid, Medicare, and insurance companies for submission of claims, to verify coverage, to determine status of claims, and to resolve issues and problems with the claims.
• Reviews incoming correspondence and materials.
• Maintains a variety of files, logs, and registers.
• Operates office equipment
• Reviews insurance information in computer registration to determine accuracy and make changes as needed.
• Opens mail and processes all patient payments, insurance reimbursements, and reconciles daily report with checks received.
• Maintains updated knowledge of FQHC billing rules, CPT, CDT, and ICD-10 coding.
• Maintains patient confidentiality according to health center policy and HIPAA regulations.
• Performs miscellaneous job-related duties as assigned.

QUALIFICATIONS:

EDUCATION/CERTIFICATION: High School Degree or GED Required.

REQUIRED KNOWLEDGE: Successful completion of in-house training.

EXPERIENCE REQUIRED: Experience with healthcare billing preferred.

SKILLS/ABILITIES:

• Understanding of different types of insurance (Medicaid, Medicare, Commercial, etc.)
• Computer experience, skill and typing ability sufficient to operate the practice management.
• Knowledge of basic medical terminology.

WHAT WE OFFER:

• Starting pay $21.60 and goes up based on experience in Federally Qualified Health Center billing
• Paid Time Off (PTO) – Accrued per pay
• Insurance (Medical, Dental, Vision, Life and Disability)
• Paid Holidays – 7 paid holidays
• 403b Retirement with up to 8% match (starts at 3% and increases with time of service at HPWO)
• Annual Reviews and Increases
• Employee Assistance Program
• Referral Bonus – Earn more by expanding our team
• Training Opportunities
• Eligible to apply for the Emerging Leaders Program after 1 year of service