Billing Specialist
On-siteToledo, Ohio, United States
Job Summary
Correct and submit unbilled claims with missing diagnostic codes, signatures, or pending statuses while monitoring claim status and following up on rejections or denials. Contact payers regarding overpayments, underpayments, and recoupments within 30 days of identification and process insurance write-offs for duplicates or payer errors. Ensure client demographic and insurance information is accurate in the EHR system, perform monthly insurance verifications, and address billing inquiries professionally. Collaborate with clinical staff to ensure documentation and coding support timely and accurate billing while maintaining compliance with Ohio Medicaid, HIPAA, and OAC standards. Utilize ClinicTracker to generate and submit regular reports monitoring revenue performance and assist with credentialing individual providers with Ohio Medicaid and private insurance carriers.
Required Qualifications
- Minimum 2 years of experience in medical billing
- Strong understanding of Ohio Medicaid billing guidelines
- Strong understanding of third-party insurance claim processes
- Proficiency in EHR systems such as ClinicTracker, CareLogic, or inSync
- Working knowledge of CPT/ICD-10 coding
- Working knowledge of insurance authorization
- Working knowledge of HIPAA compliance
- Excellent communication and interpersonal skills
- High level of accuracy, attention to detail, and ability to meet deadlines
- Comfortable using inclusive, affirming, and culturally responsive language
- Must meet all privacy and security requirements for remote work
Desired Qualifications
- Experience in behavioral health or mental health services
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