Medical Billing Specialist - Medicare Advantage

Medical Billing Specialist; Lima (OH); On-site; USD 38,000 - 52,000; Full time

Job summary

Health Partners of Western Ohio in Lima, OH is seeking an Accounts Receivable Specialist to support the revenue cycle by processing, submitting, and following up on insurance claims for Medicare Advantage payers in accordance with FQHC requirements.

The role focuses on reviewing coverage and demographics for billing accuracy, reconciling remittances, and actively managing accounts receivable aging with timely follow-ups to maximize collections.

Qualifications

• Knowledge of FQHC billing requirements.
• Prepare, submit, and follow up on insurance claims to Medicare Advantage payers.
• Monitor accounts receivable aging and actively follow up on unpaid or underpaid claims.

Responsibilities

• Review insurance coverage and patient demographic information to ensure accuracy before billing.
• Prepare, review, submit, and track insurance claims to Medicare Advantage payers in accordance with FQHC, state, and federal requirements.
• Process reimbursements and reconcile remittance reports with payments.
• Monitor AR aging and follow up on unpaid or underpaid Medicare Advantage claims.

Skills

Accounts receivable

Insurance claims processing

Medicare Advantage billing

Data accuracy

Billing compliance

Job description

Fulltime In Person (Monday - Friday 8:00 am - 4:30 pm)

About Us

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.

SUMMARY:

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

ESSENTIAL FUNCTIONS AND BASIC DUTIES:

• Review insurance coverage and patient demographic information to ensure accuracy and completeness prior to billing
• Prepare, review, submit, and track insurance claims to Medicare Advantage payers in accordance with FQHC, state, and federal billing requirements
• Process insurance reimbursements and reconcile remittance reports with payments received
• Monitor accounts receivable aging and actively follow up on unpaid or underpaid Medicare Advantage Claims.