Medical Claims Specialist

3 weeks ago


Cincinnati, Ohio, United States TriHealth Full time

Job Description

The Medical Biller II plays a crucial role in ensuring the timely and accurate submission of medical claims. This position requires strong analytical and communication skills, as well as the ability to work effectively in a team environment.

Key Responsibilities:

  • Assist the lead medical biller and fellow billing staff in submitting accurate and clean claims.
  • Ensure timely follow-up on claims and collaborate with other teams to resolve denied claims.
  • Review, investigate, and resolve credit balances.
  • Provide excellent customer service skills by answering patient and third-party questions and addressing billing concerns in a timely and professional manner.

Requirements:

  • High School Degree or GED.
  • Billing knowledge that includes ICD-9, ICD-10, and CPT terminology.
  • Epic and Clearing House experience.
  • Working knowledge of insurance policies and appeals.
  • Consistently meets individual productivity incentive standards.
  • 3-4 years of experience in a related field.

Working Conditions:

The Medical Biller II will work in a fast-paced environment, requiring strong organizational and time management skills. The position involves frequent use of computer software and communication with patients and healthcare professionals.

TriHealth SERVE Standards:

At TriHealth, we believe in serving our patients, communities, and team members with excellence and compassion. As a Medical Biller II, you will be expected to demonstrate and live the following standards:

  • Serve: Welcome everyone by making eye contact, greeting with a smile, and saying "hello". Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist.
  • Excel: Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met. Offer patients and guests priority when waiting (lines, elevators).
  • Respect: Respect cultural and spiritual differences and honor individual preferences. Respect everyone's opinion and contribution, regardless of title/role.
  • Value: Value the time of others by striving to be on time, prepared, and actively participating. Pick up trash, ensuring the physical environment is clean and safe.
  • Engage: Acknowledge wins and frequently thank team members and others for contributions. Show courtesy and compassion with customers, team members, and the community.


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