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Administrative
Medical Biller
Euclid, OH
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$22-$30 per hour, based on experience, qualifications, and certification About Village of Healing Village of Healing is a nonprofit healthcare organization committed to providing accessible, high-quality, culturally responsive healthcare and supportive services to individuals and families throughout Northeast Ohio. Our services include women's health, primary care, pediatrics, behavioral health, and integrated support services. We are seeking an experienced and highly accountable Revenue Cycle Billing & Coding Specialist to support accurate billing, timely reimbursement, denial management, and strong revenue-cycle performance. Position Summary The Revenue Cycle Billing & Coding Specialist is responsible for coding review, charge capture, claim submission, payment posting, denial management, accounts receivable follow-up, and identification of reimbursement barriers. This position works under the direction of the Director of Operations and collaborates with clinical, administrative, finance, and external credentialing partners as needed. The ideal candidate will take ownership of assigned claims from initial review through final resolution and help identify recurring issues that delay or prevent reimbursement. Key Responsibilities Review patient encounters and provider documentation for billing accuracy and completeness. Assign or validate appropriate CPT, HCPCS, and
ICD-10-CM
codes. Ensure billable encounters are captured and claims are submitted within established timelines. Monitor unbilled encounters and outstanding documentation. Prepare and submit clean claims to Medicaid, Medicare, Medicaid Managed Care Organizations, commercial insurers, and other payers. Monitor rejected, denied, unpaid, and underpaid claims through final resolution. Prepare corrected claims, reconsiderations, and appeals when appropriate. Follow up with insurance companies regarding claim status and payment. Monitor accounts receivable and prioritize follow-up based on age, dollar value, and filing deadlines. Prevent avoidable timely-filing losses. Post insurance and patient payments accurately and timely. Review remittance information and identify underpayments, adjustments, or discrepancies. Identify recurring denial trends and recommend corrective action. Identify documentation, coding, registration, credentialing, or payer issues affecting reimbursement. Communicate billing and documentation concerns to providers and staff. Provide feedback and education regarding recurring coding or documentation issues. Maintain clear documentation of work performed and productivity. Prepare regular revenue-cycle reports for the Director of Operations, including claims submitted, denials, unpaid claims, accounts receivable, payments, and outstanding issues. Participate in revenue-cycle and quality-improvement meetings as needed. Maintain HIPAA compliance and patient confidentiality. Perform other billing and coding duties as assigned. Qualifications Required High school diploma or equivalent. Previous hands-on medical billing, coding, accounts receivable, or revenue-cycle experience. Demonstrated experience resolving denied, rejected, and unpaid claims. Working knowledge of CPT, HCPCS, and
ICD-10-CM
coding. Knowledge of insurance claims, reimbursement, payment posting, and accounts receivable processes. Strong attention to detail, organization, and follow-through. Ability to work independently and manage multiple priorities. Strong communication, analytical, and problem-solving skills. Ability to maintain confidentiality and appropriately handle protected health information. Preferred Medical billing or coding certification such as CPC, CCS, CCA, CPB, or equivalent. Three or more years of medical billing, coding, or revenue-cycle experience. Experience with Epic and RSL billing workflows, work queues, claim edits, denials, and accounts receivable. Experience with Ohio Medicaid and Ohio Medicaid Managed Care Organizations. Experience with Medicare and commercial payers. Experience in primary care, women's health, behavioral health, pediatrics, or multispecialty outpatient care. Experience identifying credentialing-related claim issues. Performance Expectations The successful candidate will be expected to: Maintain a high level of billing and coding accuracy. Submit claims in a timely manner. Consistently follow up on denied, rejected, and unpaid claims. Monitor unbilled encounters and outstanding accounts receivable. Reduce preventable billing errors and denials. Prevent unnecessary timely-filing losses. Accurately post and reconcile payments. Identify recurring revenue-cycle problems and recommend corrective actions. Maintain clear documentation of work completed. Meet established productivity and quality standards. Provide timely revenue-cycle reporting to the Director of Operations. Support Village of Healing's revenue growth and long-term financial sustainability. Compensation and Benefits $22-$30per hour, based on experience, qualifications, and certification Paid time off and holidays Professional development opportunities Collaborative work environment Opportunity to contribute to the financial sustainability and growth of a mission-driven community organization Equal Opportunity Statement Village of Healing is committed to providing equal employment opportunities to all qualified individuals. We value diversity, inclusion, and a workplace environment where employees are treated with dignity and respect.
Pay:
$22.00 - $30.00 per hour Expected hours: 32.0 per week