MEDICAL BILLING SPECIALIST

Position Overview

The Billing Specialist provides accurate and timely revenue cycle and account management services to OBS member clients. This role requires strong attention to detail, analytical thinking, technical skills and communication skills to deliver high-quality customer service and support members' financial health. The specialist will contribute to OCHIN's key performance indicators by identifying and resolving claims issues, maintaining compliance with payer requirements, and engaging in continuous process improvement. A billing specialist may provide high-quality billing and customer service support to OCHIN Billing Services (OBS) member clinics and their patients, with responsibilities that may include managing self-pay accounts and customer inquiries or handling daily claims production, including printing, mailing, and preparing documentation for clean claim submission.

Essential Functions

• Execute Accurate and Compliant Billing Operations: Process claims, manage accounts receivable, and maintain documentation in compliance with payer guidelines and OCHIN systems.
• Resolve Billing Issues and Support Financial Outcomes: Investigate and resolve claim denials, identify trends, and contribute to process improvements that enhance reimbursement outcomes.
• Collaborate with Internal Partners and Stakeholders: Communicate effectively with team members and stakeholders to clarify billing requirements and contribute to a cooperative work environment.
• Organize and Prioritize Daily Responsibilities: Use OCHIN tools and processes to track deadlines and plan billing activities for timely and efficient task completion.
• Apply Healthcare and System Knowledge: Demonstrate foundational understanding of the U.S. healthcare system and apply knowledge of OCHIN solutions to billing operations.
• Other duties as assigned.

Requirements

• Experience in billing and / or coding revenue cycle experience preferred.
• Working knowledge of Medicare, Medicaid, MVA, Workers Comp and private insurance billing and reimbursement processes, legal requirements knowledge preferred.
• Experience billing for California highly preferred.
• FQHC Experience and knowledge preferred.
• California Billing experience preferred.
• Medical Billing Certification from the American Academy of Professional Coders (AAPC), preferred.
• For Acute Care hospital work, rural hospital experience is required.

Work Location and Travel Requirements

OCHIN is a 100% remote organization with no physical corporate office location. Employees work remotely from home and many of our positions also support our member organizations on-site for new software installations. Nationwide travel is determined based on OCHIN business needs. Please inquire during the interview process about travel requirements for this position.

Work From Home Requirements

• 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 required up to 20% nationally for on-site Go Live support based on business requirements for OCHIN

Pay

$20.48 - $32.77 per hour