Records Management Specialist I (Medical Billing)

Job Title: Medical Billing Specialist (Records Management Specialist)
Location: Oklahoma City, OK
Schedule: Monday – Friday, hours to be determined
Pay: $18.50 - $21.88 (based on experience)

Job Overview
Responsible for the outpatient billing cycle for client services rendered at the county health departments. Reviews and submits medical claims to third-party payers. Researches and determines appropriate actions for correcting rejected and denied medical claims. Reconciles claims and posts any adjustments, transfers, and/or payments to patient accounts. Assists in identifying medical billing issues that require further attention.

Qualifications

• 2 or more years of experience in a medical or behavioral health office or an associates degree in a related field or equivalent combination of education and experience. Can substitute six semester hours completed at an accredited college or university for each six months of required experience or the completion of a vocational training course in medical billing.
• Knowledge insurance benefit verification, authorization / referral guidelines, coding and data entry experience – serves as a customer service representative to individual clients
• Ability to analyze problems and propose solutions
• Knowledge of Medicare, Medicaid, and third-party insurance uniform billing process and procedures
• Familiar with denial codes and appropriate resolution
• Experience with public health medical billing is a plus
• Bilingual – English / Spanish is a plus

Responsibilities and Duties

• Review rejected claims in the clearinghouse for errors; determine steps to resolve the errors; and take corrective action for claims resubmission.
• Review denied claims in the clearinghouse and in Medicaid UCE files for denial reasons; determine steps necessary for successful claims submission based on those reasons according to payer contracts and requirements; and take corrective action to resubmit claims for maximum reimbursement.
• Provide centralized facilitation and monitoring of requests for prior authorizations for services when required by payer contracts.
• Enter payment and non-payment data from remittance advice (RA) to reconcile claims in the billing system, which includes identifying and documenting the appropriate adjustment or non-payment reason; file paper RAs.
• Identify and troubleshoot anomalies and possible errors in the claims process and communicate verbally and in writing to supervisor for further analysis.
• Communicate and follow up with county health department staff to assist in correcting claims at the client level.
• Respond to inquiries in the Medical Billing inbox and that arise via phone in a professional and timely manner.
• Attend trainings to maintain and improve medical billing knowledge and skills.
• Assist with provider credentialing and access to provider portals.

Why Work for Galt Foundation
Galt Foundation is a non-profit staffing agency with the mission to provide, promote, and expand employment opportunities for individuals with disabilities. We give priority in hiring individuals with disabilities including medical, physical, and psychological conditions.

Galt has and will continue to create a better workplace – one in which employers have access to skilled and motivated workers, and people of all abilities can find meaningful, sustaining work.
A devoted and friendly team that is there to help you every step of the way in advancing your career.

Job Application Process
Galt Foundation utilizes online forms and electronic signatures throughout the hiring process. As an employer of people with disabilities, we understand assistance or accommodation may be required. Should you need to complete an application in-person at a Galt Foundation office, please email recruiting@galtfoundation.org. In-person assistance is available in Salem, Oregon and Oklahoma City, Oklahoma.

Note: Please allow five (5) business days to process your application.


IND-1