Professional Billing Representative| Professional Billing, Full-Time

Memorial Health; Marysville (OH); On-site; USD 52,000 - 62,000; Full time

Job summary

Memorial Health is seeking a Professional Billing Representative in Marysville, OH. This role focuses on timely, accurate insurance claims submission and coordination of benefits within a collaborative hospital team.

Responsibilities include claims processing, payer communications, and accurate documentation in the Health Information System, with emphasis on HIPAA compliance and quality customer service.

Qualifications

• High school diploma or equivalent required.
• Three years’ experience in the medical field, preferably in a hospital setting.
• Knowledge of revenue cycle functions, health insurance and government programs, billing processes and managed care contracts.
• Ability to interpret explanation of benefits and communicate effectively.

Responsibilities

• Ensures insurance claims are sent timely and accurately to government, commercial and managed care plans.
• Researches and resolves claim edits via Epic Work Queues and external billing software.
• Prepares and processes secondary and tertiary insurance claims.
• Verifies and updates patient account demographic and financial information.
• Enters complete account notes in HIS and coordinates with departments for authorization and coding.

Skills

Billing knowledge

Communication

Education

High school diploma or equivalent

Tools

Microsoft Word

Excel

PowerPoint

Job description

Job Category: Administrative/Clerical

Requisition Number: PROFE004923

• Posted : January 28, 2026
• Full-Time

Locations

Showing 1 location

Memorial Hospital
Marysville, OH 43040, USA

Description

We are looking for a Professional Billing Representative to join our collaborative team at Memorial Health!

What You'll Do:

Billing Functions:

• Ensures insurance claims are sent timely and accurately to government, commercial and managed care plans, adhering to payer timely filing requirements
• Researches and resolves claim edits via Epic Work Queues (WQ) and/or external billing software, including electronic and paper processing
• Prepares and processes secondary and tertiary insurance claims completing coordination of benefit tables accurately reflecting prior payer reimbursement
• Ensures compliance and billing requirements for Worker’s Compensation (WC) and third-party liability claims are met
• Ensures claims submission with all appropriate documentation, using the Release of Information (ROI) module in Health Information System (HIS)
• Verifies and updates patient account demographic and financial information, processing Real-Time Eligibility (RTE); contacting account guarantor and/or payer as appropriate for demographic and financial clarification
• Enters complete and appropriate account note(s) in HIS identifying actions taken to reconcile claims
• Works various hospital departments to ensure all authorizations, coding and charge information is in place to expedite clams processing and accurate account reimbursement
• Understands Medicare Common Working File (CWF) and how to determine primary payer based on Medicare Secondary Payer Questionnaire (MSPQ)
• Works in conjunction with various physician offices; providers and managers, to obtain billing and coding information

Accounts Receivable Management:

• Manages account review and processing from system WQs, insures timely follow-up on all unpaid claims within appropriate billing cycle; manages system denial remark module, taking steps to rectify current denial
• Contacts payers via payer websites and telephone for claim status and/or clarification on denied claims
• Manages outstanding accounts receivable per departmental standards; maintains each payer’s outstanding receivables at or above departmental established goals
• Prepares and submits appeals, collecting all pertinent documentation; filing per each individual payer’s guidelines

Customer Service:

• Supports all team members and co-workers, engaging in positive interactions at all times
• Exhibits professional communication with customers, family members, co-workers, vendors and payers, by providing helpful assistance and responding timely to requests.
• Insures active listening prior to responding, remains calm and confident when assisting others
• Demonstrates a strong representation of Memorial Health’s values through attitude, actions and communications with others
• Addresses patient concerns and complaints and provides resolution for readily resolved issues; escalates more in-depth issues as appropriate to assist with service recovery
• Displays enthusiasm while applying quick thinking and resourcefulness in providing assistance

Critical Thinking:

• Actively looks for and creates opportunities to improve department, staff and personal development
• Develops and demonstrates knowledge of current developments in field to maintain competency
• Utilizes hospital and departmental policies and procedures

Interpersonal:

• Acts as a resource for new employees and precepts as needed
• All interactions are conducted in a professional manner
• Demonstrates a positive attitude
• Provides excellent customer service, facilitates quality care delivery and fosters an atmosphere of understanding cultural diversity
• Communicates dissatisfaction with issues to direct supervisor; actively contributes to the solution of problems and refrain from promoting dissatisfaction among co-workers
• Must be a team player; cooperate with co-workers to resolve conflict through one on one negotiation or with the assistance of the Director or their designee
• Maintains confidentiality at all times to protect patient’s privacy and maintains HIPAA privacy and security regulations

Documentation:

• Documents accurately (painting a complete picture providing directions to other health care providers); refrains from using unapproved abbreviations in written or computer documentation
• Documentation is completed on a daily basis
• Understands the importance of accurate completion of documentation and Hospital accreditation requirements and how it impacts hospital payment and certification programs

Education:

• HIPAA privacy regulations and related procedures
• CMS updates on patient rights

Other:

• Exhibits behaviors reflective of Memorial’s core values: Compassion, Accountability, Respect, Excellence, and Service
• Demonstrates regular and predictable attendance.
• Attends all mandatory education and in-services (i.e., team training, safety, infection control, etc.); completes mandatory health requirements.
• Employee performs within the prescribed limits of the hospital’s and department’s Ethics and Compliance program and is responsible to detect, observe and report compliance variances to their immediate supervisor, or upward through the chain of command, the Compliance Officer, or the hospital hotline.

Performs other duties as required or assigned.

Attends all mandatory education and in-services (i.e., team training, safety, infection control, etc.)

Requirements

• High school diploma or equivalent
• Three (3) years’ experience in the medical field preferably in a hospital setting.
• Knowledge of revenue cycle functions, understanding of health insurance and government programs, billing processes, managed care contracts, coordination of benefits with ability to interpret explanation of benefits desired.
• Knowledge of office practices and procedures, medical terminology and the ability to communicate effectively. Must be proficient with Microsoft Word, Excel and PowerPoint.

Shift

1st

Hours

80 per pay (Every two weeks)

Location

• Approx. 25 minutes away from Dublin, OH
• Approx. 30 minutes away from Hillard, OH
• Approx. 30 minutes away from Delaware, OH
• Approx. 30 minutes away from Powell, OH

We look forward to seeing your application!

It is our commitment to inclusivity and diversity and our ongoing determination to provide a welcoming and inclusive environment for all staff and guests of the Hospital, regardless of age, color, disability, gender, gender expression or gender identity, genetic information, national origin, race, religion, sexual orientation, or veteran status. For any questions or needed accommodations, please contact Memorial Health Human Resources at 937.578.2701.

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.