Billing Specialist II

We are seeking a Medical Billing Specialist II to join our team!

Rocking Horse Community Health Center (RHCHC) is a Federally Qualified Health Center (FQHC) that provides healthcare services to some of the area’s most vulnerable populations.

This position is responsible for managing more complex billing functions, including claim resolution, denial management, and payer-specific requirements.  This role requires the ability to independently analyze and resolve billing issues while supporting overall cash flow and compliance.   Key responsibilities include review, prepare and submit complex medical claims, conduct detailed account follow-up with insurance companies for proper reimbursement, identify causes of denials, post payments, adjustments and maintain detailed and compliant account notes for all billing activity.  This is a possible hybrid remote position.

We offer a generous compensation package; Medical, Dental & Vision benefits, Company paid life, LTD insurance, and the potential to earn and accrue up to 4 weeks of PTO per year along with 10 paid holidays.  

RHCHC is located within walking distance of downtown Springfield, which offers a wonderful variety of locally owned & operated eateries, bakeries & coffee shops.  Springfield is centrally located between Dayton & Columbus, which offers a high quality of life, and low cost of living in Southwestern Ohio.  Clark County has excellent school systems and is home to Clark State College and Wittenberg University.

To apply, and learn more about our mission driven organization, please visit our website @ www.rockinghorsecenter.org. All inquiries are confidential.

Position Info:

Position Title: Medical Billing Specialist II

Primary Service Center: Springfield, Ohio (South Limestone Location)

FLSA Status:  Non-Exempt – Hourly position

Work Hours: Full-time position

Education Requirements:

High school diploma or (GED) required, associate’s degree or certification in medical billing/coding is a plus. 

4 to 6 years of experience in medical billing, revenue cycle, or healthcare finance is preferred.

Proficiency with CPT, ICD-10, and HCPCS coding systems is required.

Ability to work independently and manage a high-volume workload.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• High school diploma or equivalent required; associate degree or certification in medical billing/coding preferred
• 4-6 years of experience in medical billing, revenue cycle, or healthcare finance
• Strong knowledge of insurance guidelines, claim lifecycle, and reimbursement processes
• Proficiency with CPT, ICD-10, and HCPCS coding systems
• Experience with EHR/EMR systems and billing software
• Ability to work independently and manage a high-volume workload
• Strong analytical, problem-solving, and organizational skills
• Excellent communication skills for payer and internal interactions

Preferred Skills:

• Experience with denial management and appeals processes
• Familiarity with multiple payer types (Medicare, Medicaid, commercial insurance)
• Ability to identify trends and suggest process improvements
• Knowledge of clearinghouses and electronic claim submission systems
• Basic reporting and Excel skills for tracking and analysis

Work Environment: In Office/possible hybrid remote.  Productivity, quality, and turnaround time expectations apply.  May handle escalated and high-priority accounts.

1. Language Skills: Ability to read and comprehend simple instructions, short correspondence and memos. Ability to write simple correspondence. Ability to effectively present information in one –on –one and small group situations to customers, clients, and other employees of the organization.
2. Mathematical Skills: Ability to add and subtract multiply and divide in all units of measure using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent and draw and interpret bar graphs.
3. Reasoning Ability: Ability to apply common sense understanding to consistently carry out instructions furnished in written, oral or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
4. Certificates, Licenses, Registration: A current Ohio driver’s license and an acceptable driving record. An individual who poses a direct threat to the health and safety of himself/herself or others in the workplace will be deemed not qualified for this position.
5. Other Skills and Abilities: The duties of this position are performed within the mission, vision, and values as defined by the Board of Directors. Must demonstrate an understanding of the role of Federally Qualified Health Centers as a safety net for all persons without regard for their ability to pay for services; appreciate patient-centered care in a medical home; and be committed to quality, comprehensive services through a team approach.

1. Confidentiality: The individual understands that the highest standard of confidentiality is essential.  Required to understand the privacy policies and procedures. Patient Health Information (PHI) and Employee Information is confidential, only the minimal amount of PHI or Employee information necessary to accomplish the internal purpose is to be shared or released.
2. Adaptability: Ability to keep receptive to change and new ideas for improvement of work processes.  Ability to consistently follow instructions, both verbal and written, as well as established policies and procedures.
3. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit and stand; use hands to fingers, handle or feel and talk and hear. The employee is frequently required to walk. The employee is occasionally required to reach with hands and arms. The employee must occasionally lift and or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
4. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The position involves regular interaction with patients and other members of the general public.  The noise level in the work environment is usually moderate. Occasional exposure to blood, body fluids, or tissues may occur. Schedule is dependent upon organization needs and may include evenings and weekends. May be sent home if demand is low or be requested to work overtime when demand is high.