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Medical Billing Specialist II

2 months ago

Columbus Ohio, United States Ohio State University Physicians, Inc. Full time

Overview:
Are you interested in becoming a part of a dedicated team at Ohio State University Physicians, Inc. where patient care and professional development go hand in hand?

About Us:


At Ohio State University Physicians, Inc., we operate over 100 state-of-the-art outpatient facilities, committed to delivering outstanding patient services while nurturing a collaborative workplace. Our diverse team comprises over 1,800 professionals, including nurses, medical assistants, physicians, advanced practice providers, administrative staff, IT experts, financial analysts, and leaders, all contributing to our mission.

As a member of Ohio State University Physicians, Inc., you will play a crucial role in enhancing healthcare, education, and career advancement.

Our Culture:

We embrace a culture founded on the principles of inclusion, empathy, authenticity, and perseverance. We strive to meet our teams where they are, uniting to support one another and our community.

Our Benefits:

Understanding the importance of options and comprehensive benefits, Ohio State University Physicians, Inc. prioritizes the wellbeing of our employees. We offer a flexible and competitive benefits package that includes medical, dental, vision, health reimbursement accounts, flexible spending accounts, and retirement plans. Additionally, we provide an employee assistance program, paid time off, holidays, and a wellness initiative aimed at helping our employees lead fulfilling lives.
Key Responsibilities:


- Review, verify, and correct patient demographics and insurance details, including medical diagnoses and service information necessary for processing insurance claims and determining coverage eligibility.


  • Analyze and coordinate Explanation of Benefits (EOB) for denials and discrepancies, implementing necessary actions and reprocessing claims in line with company policies.
  • Investigate and resolve unpaid claims promptly to optimize reimbursement.
  • Research and clarify missing or conflicting patient information; request additional documentation for denied claims or special processing needs.
  • Update work queues and invoices for collection activities in accordance with departmental guidelines.
  • Accurately reconcile accounts, adjusting balances to reflect denials, payments, and other modifications.
  • Identify trends affecting revenue, communicate issues to management, and participate in analysis and solutions to minimize denials.
  • Follow up on accounts receivable research projects, reviewing account statuses and actions taken, and provide updates to management.
  • Provide resolution for denial issues and follow-up inquiries as necessary.
  • Exhibit professionalism, punctuality, attention to detail, and courteousness in interactions with colleagues, vendors, and patients.

Qualifications:


- High School diploma or equivalent with a minimum of two years of experience in medical billing, or a comparable combination of education and experience.

Knowledge of insurance carrier payment policies and practices is essential.

Basic computer proficiency is required, along with strong organizational and problem-solving skills, and the ability to manage multiple priorities effectively.

Excellent verbal and written communication skills are necessary.

Attention to detail is crucial in composing, typing, and proofreading materials, as well as in establishing priorities and meeting deadlines.

Ability to work under time constraints and respond to various staff requests is important.

Must be capable of interacting and communicating with individuals at all organizational levels.


Preferred Qualifications:
Experience with EPIC, Claim Logic, and Imaging software systems; CPC Certification is advantageous.

Compensation:
USD $25.59 /Hr.