Medical Billing Specialist

Job Description

Job Description

Simon Eye and Center for Advanced Eye Care are partner practices with a combined 27 Optometrists, 8 Ophthalmologists, and over150 staff serving patients across the state of Delaware, Pennsylvania and Maryland. We are aligned to ensure our communities can access patient-centered, medically oriented full service eyecare delivered in convenient locations with friendly, knowledgeable doctors and staff.

Under direct supervision, the Medical Billing Specialist will be responsible for reviewing, submitting and following up on medical insurance claims in order to receive payment for services; and performs other related duties as required.

What You'll Do: 

• Receive, review and enter client information into electronic health record; verify insurance coverage.
• Scrub and submit electronic and paper billing claims to Medicaid, Medicare and private insurance companies for health care services.
• Receive payments, reconcile with remittance advice and verify/post all payments into electronic health record system daily.
• Reconcile EFT, check and credit card payments with payment postings and reports. Prepare daily deposit.
• Resolve claim denial issues promptly to help ensure timely payments.
• Provide timely notation of action on Accounts Receivable items. Initiate collection of account balances, locate and collect past due accounts, and establish payment plans with clients.
• Communicate effectively with both patients and insurance companies concerning claims.
• Review electronic health record encounter note to verify charges submitted to the electronic superbill (ESB) are accurate and add modifiers as needed.

What You'll Need:

• Two years of full-time medical billing experience, which includes proficiency working in electronic health record systems, CPT and ICD-10 coding, posting payments and clinic billing; OR an equivalent combination of related training and experience.
• Knowledge of electronic health record system used by department.
• Ability to read and interpret insurance remittance advice.
• Ability to collect, verify and enter data; present information and data in report format.
• Ability to prioritize work to ensure established timelines are met.
• Ability to follow directions and carry out projects independently
• Ability to identify problems and find solutions.
• Ability to communicate effectively, both orally and in writing.
• Ability to maintain confidentiality of information encountered in the course of work and adhere to all HIPAA guidelines/regulations.

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