Clerical Assistant III

Company Description

UHN is Canada’s #1 hospital and the world’s #1 publicly funded hospital. With 10 sites and more than 44,000 TeamUHN members, UHN consists of Toronto General Hospital, Toronto Western Hospital, Princess Margaret Cancer Centre, Toronto Rehabilitation Institute, The Michener Institute of Education and West Park Healthcare Centre. As Canada's top research hospital, the scope of biomedical research and complexity of cases at UHN have made it a national and international source for discovery, education and patient care. UHN has the largest hospital-based research program in Canada, with major research in neurosciences, cardiology, transplantation, oncology, surgical innovation, infectious diseases, genomic medicine and rehabilitation medicine. UHN is a research hospital affiliated with the University of Toronto.

UHN’s vision is to build A Healthier World and it’s only because of the talented and dedicated people who work here that we are continually bringing that vision closer to reality.

www.uhn.ca

Job Description

Union:  CUPE Clerical bargaining unit
Number of vacancies:   1
New or Replacement Position:  Replacement
Site:  Toronto General Hospital
Department:     Nephrology
Reports to:   Physician
Hours: 37.5 hours per week
Wage Range:  $23.14 - $28.92 per hour
Shifts: Days
Status: Permanent Full-Time
Closing Date: October 19, 2026

Job Summary

As an integral member of the Division of Nephrology, the Billing Specialist is responsible for the accurate and timely preparation, submission, reconciliation, and monitoring of physician billings related to inpatient and outpatient nephrology services. The candidate will provide specialized support for hemodialysis, transplant, and ambulatory nephrology billing activities across multiple sites and satellite dialysis centres.

The Billing Specialist attends daily morning report meetings to identify billable encounters, gather information regarding patient care activities, and ensure complete capture of physician services. Responsibilities include reviewing clinical documentation within the electronic medical record, generating physician billings using approved Ontario billing software, identifying billing opportunities, resolving discrepancies, maintaining billing records, and providing reports to Division leadership.

The candidate is expected to maintain current knowledge of Ontario Health Insurance Plan (OHIP) billing requirements, nephrology-specific fee codes, and applicable Ministry of Health policies.

Duties

Inpatient Billing

- Attends daily handover meetings to maintain accurate records of billable MD clinical activities. 
- Generates and submits physician billings for inpatient nephrology services, including transplant.
- Reviews clinical documentation and patient encounters to ensure completeness and accuracy of submitted claims.
- Verifies patient lists and physician and team assignments.
- Identifies missing documentation and follows up with physicians to obtain required information.
- Submitted billing optimizes resources while remaining in keeping with the most current MOHLTC/OHIP regulations

OUTPATIENT HEMODIALYSIS BILLING

- Generates physician billings for outpatient hemodialysis services at Toronto General Hospital and affiliated programs – satellite and off site outpatient units.
- Maintains records of patient encounters and physician coverage assignments.
- Ensures accurate billing according to applicable nephrology and dialysis fee schedules.

AMBULATORY AND CLINIC BILLING

- Supports MD administrative assistants through ongoing review of their outpatient billing activities and assurance of timely reconciliation of errors.
- Available to support skill building of administrative assistants to utilize new software, understand new OHIP policies and codes, and improve efficiencies

CLINICAL DOCUMENTATION REVIEW

- Attends daily nephrology morning report and clinical handover sessions to identify billable services and physician assignments.
- Reviews patient encounters documented in Epic and other approved clinical systems.
- Searches and reviews clinical records, consultation notes, progress notes, dialysis records, and discharge summaries necessary for billing purposes.
- Verifies service dates, locations, providers, and patient eligibility information.
- Identifies incomplete or inconsistent documentation and follows up with clinical staff.

BILLING RECONCILIATION AND QUALITY ASSURANCE

- Reviews submitted claims and payment reports to identify discrepancies, rejected claims, underpayments, and unpaid accounts.
- Investigates billing irregularities and recommends corrective actions.
- Maintains tracking systems for submitted claims, corrections, and resubmissions.
- Produces regular billing activity reports and summary statistics for physicians and Division leadership.
- Assists with audits and reporting requirements.

BILLING SYSTEMS AND DATABASE MANAGEMENT

- Utilizes Ontario and UHN approved physician billing software to generate and track physician claims.
- Maintains accurate electronic billing records and databases.
- Generates routine and ad hoc reports regarding billing activity, revenue trends, physician service volumes, and claim status.
- Assists in identifying opportunities to improve billing workflows and operational efficiency.

LIAISON WITH PHYSICIANS AND CLINICAL STAFF

- Serves as a resource to physicians and administrative assistants regarding billing requirements and documentation standards.
- Communicates in a professional and confidential manner regarding patient and physician information.
- Facilitates timely resolution of billing-related inquiries.

ONGOING PROFESSIONAL DEVELOPMENT

- Maintains current knowledge of: OHIP billing regulations
- Ontario Schedule of Benefits
- Nephrology and transplant fee codes
- Dialysis billing requirements
- Transplant billing requirements
- Virtual care billing regulations
- Ministry of Health policy updates

- Participates in relevant education sessions and professional development activities.

Qualifications

- Completion of a recognized post-secondary program in Health Information Management, Medical Office Administration, Health Administration, Accounting, Business Administration, or equivalent combination of education and experience.
- Minimum two years of experience in physician billing, healthcare administration, or medical office operations. 
- Experience with OHIP physician billing required.
- Experience within a hospital or academic healthcare environment preferred.
- Knowledge of nephrology, dialysis, or transplant services strongly preferred.
- Demonstrated knowledge of Ontario physician billing regulations and fee schedules.
- Proficiency with physician billing software currently utilized within Ontario and UHN.
- Proficiency with Epic electronic medical record systems.
- Advanced Microsoft Excel skills.
- Ability to generate detailed reports and maintain accurate databases.
- Excellent attention to detail.
- Strong analytical and problem-solving skills.
- Ability to work independently while managing competing priorities.
- Strong organizational and time-management skills.
- Excellent written and verbal communication skills.
- Strictly adheres to hospital and provincial policies relating to maintenance of .

Additional Information

Why join UHN?

In addition to working alongside some of the most talented and inspiring healthcare professionals in the world, UHN offers a wide range of benefits, programs and perks. It is the comprehensiveness of these offerings that makes it a differentiating factor, allowing you to find value where it matters most to you, now and throughout your career at UHN.

- Competitive offer packages
- Government organization and a member of the Healthcare of Ontario Pension Plan (HOOPP https://hoopp.com/)
- Close access to Transit and UHN shuttle service
- A flexible work environment
- Opportunities for development and promotions within a large organization
- Additional perks (multiple corporate discounts including: travel, restaurants, parking, phone plans, auto insurance discounts, on-site gyms, etc.)

Current UHN employees must have successfully completed their probationary period, have a good employee record along with satisfactory attendance in accordance with UHN's attendance management program, to be eligible for consideration.

All applications must be submitted before the posting close date.

UHN uses email to communicate with selected candidates.  Please ensure you check your email regularly. At University Health Network (UHN), artificial intelligence technologies may be used to assist in the screening, assessment, and selection of candidates for this position.

Please be advised that a Criminal Record Check may be required of the successful candidate. Should it be determined that any information provided by a candidate be misleading, inaccurate or incorrect, UHN reserves the right to discontinue with the consideration of their application.

UHN is an equal opportunity employer committed to an inclusive recruitment process and workplace. Requests for accommodation can be made at any stage of the recruitment process. Applicants need to make their requirements known.

We thank all applicants for their interest, however, only those selected for further consideration will be contacted.