Benefits:

401(k)

401(k) matching

Dental insurance

Health insurance

Paid time off

Training & development

Vision insurance

Qualifications

High School Diploma or Equivalent required

Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems

Proficient in Microsoft Word, Outlook, Excel, and 10 key calculators

Basic knowledge of medical terminology, including CPT/ICD-10 coding

Effective communication abilities for phone contacts with insurance payers to resolve issues

Knowledge of medical terminology likely to be encountered in medical claims

Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Planning and organizing

Attention to detail, accuracy, and efficiency

Problem-solving

Teamwork

Multitasking

Customer service

Electronic Medical Records (EMR)

Communication skills - verbal and written

Integrity

Prolonged periods sitting at a desk and working on a computer

Must be able to lift up to 15 pounds at times

Responsibilities

The Billing Specialist is responsible for posting insurance payments, entering charges, and assisting patients with their accounts

Position requires accuracy, thoroughness, and a good understanding of insurance procedures for referrals, co-pays, deductibles, allowable, CPT codes and Dx codes

Work with personal information and maintain patient confidentiality

Weekly and monthly reporting to executive director and billing supervisor

Verify the accuracy of all claims before submission and ensure all claims are submitted with a goal of zero errors and review claims and claims denials to ensure maximum reimbursement for services provided

Utilize monthly aging accounts receivable reports for follow-up on unpaid claims aged over 30 days

Review referrals and authorizations

Respond to questions and complaints from patients or insurance companies

Research and appeal denied claims

Read and interpret insurance explanation of benefits and respond to inquiries from insurance companies, patients, and providers

Other responsibilities as judgment or necessity dictate

Become OCSR (Ophthalmic Coding Specialist- Retina) certified in the first 6 months of employment. All associated costs covered.

Meet defined department goals and activity metrics

Initiate late payment notices to relevant parties

Identify and bill secondary and/or third-party insurances

Follow set billing processes and procedures and follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO

Ensure patient information is accurate and complete and request any missing patient information

Create both paper and electronic copies of documentation

Collect delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur