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Job Title: Medical Billing Clerk
Location: Upper Arlington, OH (Fully Onsite)
Employment Type: Full-Time
Salary Range: $37,440 – $42,000 annually

Position Overview

We are seeking a detail-oriented Medical Billing Clerk to join our team in Upper Arlington. This is a fully onsite role responsible for accurate medical billing, claims processing, and payment follow-up, with a strong focus on Medicaid billing and compliance.

Key Responsibilities

Process and submit medical claims accurately and timely

Handle Medicaid billing, including eligibility verification and claim follow-up

Review and resolve claim denials and payment discrepancies

Post payments and adjustments to patient accounts

Communicate with insurance companies, providers, and internal staff regarding billing issues

Maintain compliance with state and federal healthcare regulations

Ensure patient and financial data accuracy within billing systems

Required Qualifications

Medicaid billing experience is required

Prior experience in medical billing or healthcare revenue cycle functions

Strong attention to detail and accuracy

Ability to manage multiple tasks and meet deadlines

Proficiency with medical billing software and basic computer applications

Excellent communication and organizational skills

Work Environment

Fully onsite position in Upper Arlington, OH

Collaborative, professional healthcare setting

","shortDescription","

Job Title: Medical Billing Clerk
Location: Upper Arlington, OH (Fully Onsite)
Empl...","promoted","title","Medical Billing Clerk","duration","Full Time","experienceLevel","","displayThumbnail","location","locations",[64],"id",["B","3523130859"],"displayHeadline","Work at CFS","category","displayPublishedAt","1 days ago","displayUrl","/jobs/3523130859-medical-billing-clerk","shortTitle","shortLocation","Upper Arlington, OH, United States","searchCompanyPath","/jobs?keyword=CFS","searchLocationPath","/jobs?location=Upper+Arlington%2C+OH%2C+United+States","searchTitlePath","/jobs?keyword=Medical+Billing+Clerk",{"_65":66,"_67":68,"_69":57,"_70":71},"country","United States","city","Upper Arlington","formatted","state","OH",["D",1777514400000],"HMSA","
Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions.

Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departments to implement short- and long-term solutions and process improvements.

Manage open claims issues to ensure timely resolution in compliance with internal SLAs and regulatory standards.
Collaborate with internal teams to conduct training sessions and measure effectiveness of training.

Provide support for audits, appeals, and compliance-related activities

Participate in system updates, and cross-functional meetings to stay current on claims processing procedures and benefit plan designs.

Document all interactions, updates, and outcomes clearly in case management or claims systems.

Performs all other miscellaneous responsibilities and duties as assigned or directed

#LI-Hybrid

","
Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and re...","Claims Liaison Specialist",[86],["B","3533077072"],"Work at HMSA","17 hours ago","/jobs/3533077072-claims-liaison-specialist","Honolulu, HI, United States","/jobs?keyword=HMSA","/jobs?location=Honolulu%2C+HI%2C+United+States","/jobs?keyword=Claims+Liaison+Specialist",{"_65":66,"_67":87,"_69":88,"_70":89,"_90":91},"Honolulu","Honolulu, HI, United States, 96814","HI","postal_code","96814",["D",1777420800000],"

Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions.

Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departments to implement short- and long-term solutions and process improvements.

Manage open claims issues to ensure timely resolution in compliance with internal SLAs and regulatory standards.
Collaborate with internal teams to conduct training sessions and measure effectiveness of training.

Provide support for audits, appeals, and compliance-related activities

Participate in system updates, and cross-functional meetings to stay current on claims processing procedures and benefit plan designs.

Document all interactions, updates, and outcomes clearly in case management or claims systems.

Performs all other miscellaneous responsibilities and duties as assigned or directed

#LI-Hybrid

","

Function as a central communication point between claims processing teams and internal/external partners regarding claim status, i...",[98],["B","3531282571"],"/jobs/3531282571-claims-liaison-specialist",{"_65":66,"_67":87,"_69":88,"_70":89,"_90":91},["D",1777266000000],"3B Staffing LLC","Overview:
We are seeking a highly skilled Systems Analyst with strong technical and analytical expertise in healthcare claims processing and comprehensive knowledge of data across all functional areas of the Medicaid Management Information System (MMIS) or similar large-scale claims processing systems.

Key Responsibilities
Data Analysis & Conversion
- Lead end-to-end FAS data conversion strategy, including mapping, transformation logic, and reconciliation.
- Direct data validation cycles and resolve complex data anomalies to ensure accuracy and completeness of converted Member, Claims, and Finance data.
- Manage mock conversion cycles and coordinate with technical and business teams to ensure readiness for migration.
- Oversee data quality assessments and ensure converted data meets business, audit, and regulatory standards.
- Develop and document conversion crosswalks and migration procedures for transitioning legacy data into FAS.
- Partner with technical architects to optimize conversion performance, minimize downtime, and support a smooth cutover.
- Provide governance oversight on system design decisions to ensure alignment with architectural standards and operational readiness requirements.
- Perform data analysis related to data conversion from legacy systems to new platforms, including validation of mapping rules, data integrity checks, and reconciliation.
- Assist in defining and executing data validation strategies to ensure accuracy and completeness during migration efforts.
- Analyze large datasets to identify discrepancies, trends, and anomalies during conversion and testing phases.
- Develop SQL/Teradata queries for data validation, reconciliation, and reporting.

- Document
data conversion rules, transformation logic, and validation results to
support audit and compliance requirements.

- Work
closely with ETL developers and business teams to ensure data quality and
consistency across systems.

Testing & Quality Assurance

- Develop
and execute the overall Test Strategy, including System Integration
Testing (SIT), User Acceptance Testing (UAT), and End-to-End (E2E) testing
for MMIS and MES modules.

- Test
Commercial Off-the-Shelf (COTS) applications and support data conversion
and integration across MES modules and COTS products.

- Create
and support the development of Business Test Scenarios, Test Cases, and
Test Data; assist with test execution activities.

- Support
ongoing releases, system enhancements, and production defect resolution.

- Manage
defect triage calls with multiple vendors and ensure accurate tracking and
timely closure of defects.

- Communicate
UAT status, progress metrics, and results to stakeholders; maintain
comprehensive historical testing documentation.

- Collaborate
effectively with technical teams, business users, and cross-functional
groups with minimal supervision.

Required Skills and Experience

- Proven Agile Testing experience, with the ability to plan and execute functional, integration, and regression testing within iterative sprint cycles.
- Data
Analysis: Strong experience in data conversion, mapping rules,
validation, ETL design, and programming logic.

*HIGHLY DESIRED: Mgr will give preference to people who have worked on MMIS or
for Conduent (Company) in the past. Healthcare
Claims Expertise: In-depth knowledge of MMIS or similar large-scale
claims processing systems.

Technical Skills

- Proficiency
in Teradata, including query development.

- Experience
with Mainframe and DB2 testing preferred.

- Test
Management Tools: Extensive experience with Azure DevOps or similar
platforms for planning, tracking, and executing test activities.

- Defect
Management: Strong experience leading UAT and defect triage across
multiple systems/vendors.

- Problem-Solving:
Strong debugging ability and experience acting as a liaison between
developers and business users.

- Excellent
organizational and communication skills, with the ability to meet
deadlines professionally and with strong customer focus.

Skills:

Skill

Required / Desired

Amount

of Experience

Expertise Rating

Move

Exp with Large-Scale Claims Processing Software (MMIS or similar): Mgr will give preference to people who have worked on MMIS or Conduent in past

Highly desired

5

Years

Experience in Data Analysis (large datasets, trend identification)

Required

10

Years

Knowledge of Programming Logic

Required

10

Years

Experience in Data Conversion, Mapping Rules, and Validation

Required

10

Years

Experience in ETL Design and Data Transformation

Required

10

Years

Experience with Evaluating and Presenting Conversion Results

Required

10

Years

Experience with Teradata Queries and SQL

Required

10

Years

Ability to Document Data Conversion Rules and Validation Results

Required

10

Years

Experience in Data Quality Assurance and Reconciliation

Required

10

Years

Experience in Collaborating with ETL Developers and Business Teams

Required

10

Years

Experience with Azure DevOps or Similar Test Management Tools

Required

5

Years

Excellent organizational and communication skills; ability to meet deadlines with professionalism and customer focus.

Required

10

Years
","Overview:
We are seeking a highly skilled Systems Analyst with strong technical and analytical expertise in healthcare claims processing and co...","System Analyst",[113],["B","3523537105"],"Work at 3B Staffing LLC","3 days ago","/jobs/3523537105-system-analyst","Richmond, VA, United States","/jobs?keyword=3B+Staffing+LLC","/jobs?location=Richmond%2C+VA%2C+United+States","/jobs?keyword=System+Analyst",{"_65":66,"_67":114,"_69":115,"_70":116,"_90":117},"Richmond","Richmond, VA, United States, 23214","VA","23214",["D",1777280400000],"Holyoke Hospital","Medicare Follow-Up Specialist

Medicare Follow-Up Specialist is responsible for the resolution of Medicare and Medicare Advantage claims to ensure timely and accurate reimbursement. Successful candidates are expected to be familiar with Medicare regulations, accurately follow-up and resolve suspended and RTP claims, assist in completion of quarterly reporting requirements and resolution of credit balances. Responsible for timely submission of daily and monthly Medicare claims Identifying and billing secondary or tertiary insurance plans. Researching and appealing denied claims Reviewing patient bills for accuracy and completeness and obtaining any missing information from multiple sources. Responsible for timely follow-up of all outstanding Medicare Claims Communicate with third-party representatives as necessary to complete claims processing and/or resolve problem claims by phone and website.
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Medicare Follow-Up Specialist is responsible for the resolution of Medicare and Medicare Advantage claims to...","Medicare Follow-up Specialist - Billing",[131],["B","3523402720"],"Work at Holyoke Hospital","/jobs/3523402720-medicare-follow-up-specialist-billing","Holyoke, MA, United States","/jobs?keyword=Holyoke+Hospital","/jobs?location=Holyoke%2C+MA%2C+United+States","/jobs?keyword=Medicare+Follow-up+Specialist+-+Billing",{"_65":66,"_67":132,"_69":133,"_70":134,"_90":135},"Holyoke","Holyoke, MA, United States, 01040","MA","01040",1072,"name","Hearst Television","agency","logo","slug","hearst-television","
Every career with Hearst Television is like a story. How it develops, where it takes you, the milestones you reach along the way – you’ve got a lot to look forward to as your unique career story unfolds. Hearst Television, a subsidiary of Hearst, owns and operates local television and radio stations serving nearly three dozen U.S. cities, reaching 24 million U.S. television households. Through its partnership with nearly all major networks, Hearst Television distributes national content across more than 120 video channels, including programming from ABC, NBC, CBS, CW, MY Net, MeTV, This TV, Estrella, and more. Hearst Television is recognized as one of the industry's premier companies. It has been honored with numerous awards for distinguished journalism and industry innovation, including the Walter Cronkite Award for political journalism, the national Edward R. Murrow Award, the DuPont-Columbia Award, and the George Foster Peabody Award.
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