Billing Specialist – Medical

Neighborhood Health Association (NHA), a Federally Qualified Health Center (FQHC), is the largest community health center system in Northwest Ohio with partnerships that include ProMedica, Mercy Health, and University of Toledo Medical Center. NHA has grown from a single location in 1969 to 12 medical and dental clinics throughout Lucas County. Today we operate multiple health centers including pediatrics, adult medicine, dental services, health care for the homeless, women’s health center, senior centers and a full service pharmacy with lab services on site.

For more than 50 years, NHA has placed a strong focus on prevention and empowering individual responsibility in managing their health care and overall well-being. Our services are acutely responsive to the needs of everyone throughout the communities we serve, providing excellent care and the best health practices.

General Function:

Responsible for collecting, posting and managing account payments, submitting claims and following up with insurance companies. Responsible for inputting all charges incurred during on-site office visits and entering all payments received on-site. This requires that the employee remains current with specifics of all payer types. Will work with medical staff to assure that all necessary information is provided on the encounter form and must reconcile all printed forms. Will be responsible for entering all new private insurance data that is collected. On assigned days will assist the Scheduling Coordinator acting as the “Out-take Clerk”.

Duties and Responsibilities:

  • Prepares and submits clean claims to various insurance companies either electronically or by paper
  • Answer questions from patients, clerical staff and insurance companies
  • Identifies and resolves patient billing complaints
  • Prepares, reviews and send patient statements
  • Evaluates patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts
  • Reviews accounts for possible assignment and recommendations to the Billing Supervisor, also prepares information for the collection agency
  • Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers
  • Processes payments from insurance companies
  • Participates in educational activities and attends monthly staff meetings
  • Conducts del fin accordance with NHA’s employee manual
  • Maintains strictest confidentiality; adheres to all HIPPAA guidelines/regulations
  • Be sure that all encounter forms that were generated are accounted for.
  • Review each forms to assure that were generated are accounted for.
  • Follow-up with medical staff and front desk when necessary to assure proper claim submission.
  • Once satisfied that the encounter form is completed appropriately and that the account contains current data will input charges and payments.
  • Must use current CPT Coding and ICD-9 (ICD-10 effective October 2015) coding to generate good claims.
  • All payments received will be applied to designated services.
  • The day’s entries must be balanced to the cashier log.
  • Will be responsible for updating all private insurance data within accounts.
  • Will assist with patient inquires

Skills/Qualifications:

  • High School Diploma or GED
  • 1-2 years of experience in an physician or hospital billing environment preferred
  • 1-2 years of coding experience, preferred
  • Knowledge of medical billing/collection practices
  • Knowledge of computer programs
  • Knowledge of business office procedures
  • Knowledge of basic medical coding and third party operating procedures and practices
  • Ability to operate a computer and basic office equipment
  • Ability to operate a multi-line telephone system
  • Skill in answering a telephone in a pleasant and helpful manner
  • Ability to read, understand and follow oral and written instructions
  • Ability to establish and maintain effective working relationships with patients, employees, and the public
  • Must be well organized and detail-orientated
  • Familiar with computer generated billing.
  • Highly motivated and a self-starter.
  • Ability to work well under pressure and to work independently.

This position is Full-Time Monday – Friday 8:00 am- 4:30 pm, no evenings, weekends or holidays.

Excellent benefits including PTO, paid holidays, Health, Dental, Vision & 403B.

We are a drug free workplace, and an Equal Opportunity Employer.

Our Mission: Through our exceptional health care services, we empower and educate, aggressively working to eliminate health care inequities, while supporting personal responsibility for one’s own health regardless of the ability to pay.

Please apply by submitting resume to resume@nhainc.org