Billing Specialist-Ophthalmology (ON-SITE)

Job Description

Job Description

Busy ophthalmology practice focused on excellence in patient care and creating exceptional patient experiences seeking experienced Ophthalmology/Optometry Billing Specialist. We offer great pay and benefits in an exceptional team work environmeny/ Exciting opportunity! M-F, days, EOE.

• Proficient in billing claims from EHR (Nextech PM experience, a plus!), downloading and posting EFTs from Clearinghouse, claim research and resolution, refund requests, filing appeals, A/R follow-up.
• Uses eligibility tools, and is capable of checking benefits through Availity, UHC Provider/Humana Military and other payer websites.
• Experience in filing Routine claims and obtaining routine eye benefit authorizations.
• Contacts insurance carriers to verify coverage and limits as directed by policy.
• Initiates financial agreements for high-deductible health plans and co-insurances.
• Obtains appropriate prior authorizations relevant to date of service and procedure, including same day/add-on procedures, surgeries and testing.
• Contacts patients regarding balance due at time of service, and effectively communicates insurance coverage limits to patients.
• Documents all communication with patients in Practice Management system.
• Provides coverage for Front Desk, as needed.
• Participate fully as a team member in a dynamic, patient-focused, fast-paced environment.
• Researches accounts, and resolves claim issues.
• Participates and assists in in-house collection projects, as assigned.
• Participates and assists in special billing projects, as assigned.

Required Skills & Abilities:

• Experience in insurance eligibility, prior authorizations and referrals in a health care setting.
• Knowledgeable in use of Availity, UHC Provider/Humana Military websites.
• Knowledgeable of CPT/ICD-10 coding; ophthalmology experience, a plus.
• Detail-oriented with excellent organizational and time management skills.
• Excellent communication skills, both verbal and written.
• Proficiency with Microsoft Word and Excel.
• Positive attitude and demeanor.
• Ability to work in a fast-paced environment.
• Experience using a PM and EHR system (Nextech/IntelleChart,a plus!).
• Must be able to pass background and drug screening.

Excellent benefit package to include PTO, health/dental insurance, 401k. Outstanding work environment. Salary commensurate with experience.