Employer: OCHIN
Position Overview
The Medical and Dental Billing Specialist supports the mission of OCHIN by providing high quality billing services to one of more OCHIN Billing Services (OBS) member clinics. The Billing Specialist will primarily focus on payor follow-up and denial management, recognize potential high-risk accounts, and develop techniques to improve collections and streamline processes. The OBS team member will discuss difficult or unique collection problems with the Billing Supervisor, resolve issues, apply new information to future collection issues, and make suggestions to enhance our efficiency and effectiveness through process improvement with the assistance of their immediate supervisor. This position will enhance the billing department’s reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
COVID-19 Vaccination Requirement
To keep our colleagues, members, and communities safe, OCHIN requires all employees—including remote employees, contractors, interns, and new hires—to be vaccinated with a COVID-19 vaccine, as supported by state and federal public health officials, as a condition of employment. All new hires are required to provide proof of full vaccination or receive approval for a medical or religious exemption before their hire date.
Essential Duties
Medical Billing
- Provide efficient and effective account receivable services on behalf of our member clients to maximize their reimbursement and support OCHIN revenue cycle performance indicators for financial health
- Accurately bill Medicare, Medicaid, self-pay/uninsured, and commercial insurance, processing claims in accordance with payer requirements and organization policy
- Assist with the collection of receivables by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends
- Post patient payments, electronic remits, and paper explanation of benefits (EOBs).
- Correct claim and charge errors
- Thoroughly research and resolve credit balances
- Answer phone calls from patients and responsible parties regarding account balances and/or other matters. Provide compassionate and empathetic customer service
- Perform other specific projects related to billing, data entry, and computer operations as required
Account Maintenance
- Perform registration updates in Epic
- Maintain complete and accurate billing and accounts receivable records
- Send correspondence to member clinic/Client in accordance with their policies and procedures
Additional Responsibilities
- Establish and maintain positive working relationships with patients, payers, team members, clients, and other stakeholders. Maintain confidentiality of patient information, organization data and information always in compliance with HIPAA regulations
- Continuously improve understanding of collection processes and strategies by working with colleagues within OBS and OCHIN Collaborative. Other duties as assigned
Qualifications
- 1 year of progressive experience in similar or relevant role preferred. 2 years of applicable experience desired
- Minimum of a high school diploma or GED is required. Some higher education is preferred
- Previous FQHC/RHC experience preferred
- Knowledge of Medical Terminology is preferred in this role
- Working knowledge of Medicare, Medicaid, MVA, Workers Comp and private insurance billing and reimbursement processes, legal requirements knowledge
- Bilingual Preferred (English/Spanish)
- Dual language differential of 10% of base rate for intermediate to advanced in skills to speak, write and read dual languages, regardless of what language.
- Desired Certifications include:
- Medical coding from AAPC (CPC Certificate)
- AHIMA (CCS Certificate)
- Current certification from ADCA (CDC certificate)
- HFMA (CRCR certificate)
- Experience using EPIC practice management system, strongly preferred
Work Location and Travel Requirements
- This position is 100% remote. Work from home requirements are:
- Ability to work independently and efficiently from a home office environment
- High Speed Internet Service
- It is a requirement that employees work in a distraction free workplace
- Travel may be required based on business requirements for OCHIN
We offer a comprehensive range of benefits. See our website for details: https://ochin.org/employment-openings
Equal Opportunity Statement
OCHIN is proud to be an equal opportunity employer. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills for the benefit of our staff, our mission, and the communities we serve.
As an Equal Opportunity and Affirmative Action employer, OCHIN, Inc. does not discriminate on the basis of race, ethnicity, sex, gender identity, sexual orientation, religion, marital or civil union status, age, disability status, veteran status, or any other protected characteristics. All aspects of employment are based on merit, performance, and business needs.