Medical Billing Specialist

$5,000 HIRING BONUS (Prorated by FTE)

• Benefits include: 
  • Family medical, dental, long-term disability, 403(b) plan with 6% match, and more. 
  • Generous paid time off policy.  (Annual accrual up to 208 hours - based on FTE status and available to use upon accrual).  Plus, 11 paid holidays annually. 

• Bonus Applicable to external applicants only, and limitations for re-hires will apply.

Hours: Monday-Friday 8am-4:30pm

Overview

The Medical Billing Specialist assists the billing department to accurately manage patient payments and insurance claims. The specialist submits claims and/or encounters for clinical services to insurance companies, and other payers, to ensure proper reimbursement. Adheres to claim submission deadlines, posts payments and enters data into the electronic health record (EHR). Utilizes medical terminology, CPT coding, ICD coding, and HCPCS in relation to behavioral health services to process claims through the EHR. Performs quality assurance reviews to ensure clean claims are submitted. Maintains working knowledge of the State of Oregon’s diagnosis requirements for billing behavioral health services under the Oregon Health Plan and the payment structure, to properly bill for services. Responsibilities are shared among individuals; one person will not have full responsibility for every duty.  

Responsibilities

Enters required billing data into the EHR.  

Creates and generates reports to extract and verify billing data.

Organizes, prepares, and maintains detailed billing records, reports and files for billing department.  

Reviews and updates patient account charges, insurance data and demographic information in EHR software and researches missing or incorrect information that may affect claims submissions.  

Assists clinicians with coding questions and ensures coding errors are resolved so claims can be generated correctly.    

Bills primary and secondary insurance carriers within timely filing guidelines and departmental standards. 

Works with insurance representatives to problem solve denials or improper payments. Ensures claims are paid appropriately.   

Generates patient billing and ensures that these individuals have the necessary service approval status and fee agreement on file.   

Monitors the reconciliation of third party insurance remittances and cash application.

Verifies clients’ private insurance coverage and works closely with insurance providers to determine type of services covered.

Processes month end close in the medical billing system and reconciles with agency’s general accounting system.

Reviews and corrects encounter data and Medicare billing exceptions.

Maintains confidentiality, punctuality, attendance, and ethical conduct at all times. 

Qualifications

High school diploma or equivalent. 

Minimum of two (2) years of experience performing medical billing or a combination of related medical office experience and accounts receivable.

Working knowledge of the State of Oregon’s diagnosis requirements for billing preferred.

Practice strong organizational skills, effective use of time and excellent communication.

Use effective customer relations skills, including the ability to work with diverse people in a stressful environment, displaying an understanding of group dynamics and dealing with stress effectively.

Possess business experience sufficient to meet the demands of the position, including proficiency with a variety of software applications.

Must pass state-required background and DMV checks; Candidate must be able to work independently and flexibly, under general supervision. 

Options for Southern Oregon recognizes that in order to best serve the healthcare needs of our communities and fulfill our mission, we must learn, grow, incorporate, and value the principles of diversity, equity, and inclusion in our work and in our lives.  We are committed to the continued development of an aware, diverse, and culturally responsive workforce and an organizational culture that is supportive and affirming for all staff and clients.  Options acknowledges that incorporating EDI principles in our practices is an ongoing learning process and we are committed to using our voice to effect positive change.  We recognize that making an impact on health inequities in our community will take more than just a statement and, to this end, our goals, planning, and actions aim to promote and develop equitable and effective health care services to reflect the needs of our diverse communities.

Options for Southern Oregon provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.