Revenue Cycle: Medical Billing Specialist

Blanchard Valley Health System; Dayton (OH); On-site; USD 42,000 - 64,000; Full time

Job summary

Blanchard Valley Health System in Dayton, OH seeks a Medical Claims Specialist to manage pre-billing, clean claim submission, and payer follow‑up to promote timely reimbursement. You will work with HIPAA-compliant processes, use Excel and billing software, and educate other departments to ensure accurate documentation and compliant claims.

This role emphasizes auditing, problem solving, and collaboration with the hospital's revenue cycle team to improve efficiency.

Qualifications

• High school diploma or GED required; CPFSS certification within 12 months.
• Familiarity with medical terminology and HIPAA requirements.
• Proficient in Microsoft Office, especially Excel.
• Ability to manage multiple tasks and meet deadlines.
• Strong problem solving and self-directed work style.

Responsibilities

• Maintain understanding of federal/state regulations and payer policies to ensure compliant claims submission.
• Process daily electronic billing files and resolve corrections for clean first-time reimbursement.
• Identify and correct claim issues before submission; collaborate with hospital departments for ready-to-bill documentation.
• Educate staff in other departments when documentation is insufficient for billing.
• Prepare and submit manual claims for payers not accepting electronic submissions.
• Monitor error reports to identify trends and opportunities for process improvements and increased accuracy.
• Escalate outstanding holds and communicate trends to supervisor.
• Observe best practices in billing, follow up, and customer service; report compliance concerns.

Skills

Time management

Organizational skills

Problem solving

Independent work

Team collaboration

Education

High school diploma or GED

CPFSS certification within 12 months of hire

CPC certification preferred

Tools

Excel

Billing system

Microsoft Office

Job description

Blanchard Valley Health System in Dayton, OH seeks a Medical Claims Specialist to manage pre-billing, clean claim submission, and payer follow‑up to promote timely reimbursement. You will work with HIPAA-compliant processes, use Excel and billing software, and educate other departments to ensure accurate documentation and compliant claims.

This role emphasizes auditing, problem solving, and collaboration with the hospital's revenue cycle team to improve efficiency.