Clerical Assistant III

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