Medical Billing Claims Analyst

Join TriHealth as a Medical Billing Claims Analyst!

Join TriHealth and play a key role in supporting the financial health of one of Greater Cincinnati’s leading healthcare organizations. In this position, you’ll help ensure claims are submitted accurately and efficiently by monitoring clean claim performance, identifying trends, and partnering with billing teams, IT, and our clearinghouse vendor to resolve processing issues. Your expertise will directly contribute to reducing claim rejections and denials while improving workflows and supporting timely reimbursement.

At TriHealth, collaboration, innovation, and continuous improvement are at the heart of how we work. You’ll have the opportunity to use your medical billing and Epic knowledge to enhance processes, educate team members, and help strengthen standardized billing practices across the organization. If you’re an experienced billing professional with strong communication skills who enjoys problem-solving and working across teams, this is an opportunity to make a meaningful impact at TriHealth.

Apply today and grow your career with a team that truly values you.

Location:

• TriHealth Norwood Location

Work Schedule:

• Full-Time (80 Hours Bi-weekly)

• Day Shift

• No Weekend, Holiday and On Call Commitment

Incentives & Benefits:

In addition to a comprehensive benefits package - including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement - this role offers competitive shift differentials, with the opportunity to earn up to an additional $7 per hour based on shift, hours worked, and organizational guidelines. Please view our benefits page https://careers.trihealth.com/what-we-offer/benefits

Job Requirements:

• High School Diploma or GED or GED (Required)

• 4 - 5 years’ experience in related field (Required)

• Meets all requirements for Medical Biller III

• Communicates and resolves any claims issues between Clearing House and Epic IT

• Maintains payer edits from Clearing House and user security

• Reports claim volumes and trends to Management

Job Overview:

This position is primarily responsible for ensuring claims go to clearing house timely and clean daily. Daily reports will be expected to be shared with leadership to ensure a clean claim rate. This position will require an individual to act as a liaison between IT and the outside clearinghouse to maintain edits and enhancements needed to reduce rejections or denials. Assist billing team to resolve processing issues. Educate billing team regarding how to use the clearinghouse data to expedite claim processing.

Job Responsibilities:

• Ability to maintain ongoing changes with the vendor to stay innovative and keep Epic robust.

• Assists with questions from IT or clearinghouse vendor to ensure all parties agree to the workflow from Epic to the clearinghouse and vice versa.

• Maintains a close working relationship with all billing departments to consolidate efforts to ensure appropriate and standardized billing procedures are followed.

• Must be able to perform other duties as assigned by leadership.

• Must possess strong communication skills, both verbal and written: must be able to effectively communicate software and technical issues with billing team as well as the clearinghouse vendor.

• Runs daily audits to monitor clean claim rate as well as report opportunities to enhance edits in Epic.

Working Conditions:
Climbing - Rarely
Concentrating - Frequently
Hearing: Conversation - Frequently
Interpersonal Communication - Frequently
Kneeling - Rarely
Lifting <10 Lbs. - Rarely
Lifting 50+ Lbs. - Rarely
Lifting <50 Lbs. - Rarely
Pulling - Rarely
Pushing - Rarely
Reaching - Rarely
Reading - Consistently
Sitting - Consistently
Standing - Rarely
Stooping - Rarely
Thinking/Reasoning - Consistently
Use of Hands - Frequently
Color Vision - Consistently
Walking - Occasionally

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:

Serve: ALWAYS...
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas

Excel: ALWAYS...
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service

Respect: ALWAYS...
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS...
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS...
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community