Senior Billing Representative

Senior Medical Billing Representative Ophthalmic Consultants of Boston (OCB) Be Part of a Team That’s Advancing Vision Care—and the People Behind It At Ophthalmic Consultants of Boston (OCB), we don’t just deliver exceptional eye care—we build careers. As a nationally recognized leader in ophthalmology, we are proud to foster a collaborative, growth‑focused environment where expertise is valued and professional development is encouraged. We are seeking an experienced and driven Senior Medical Billing Representative to join our Revenue Cycle team. In this role, you will be a key contributor to the financial health of the organization, tackling complex billing challenges, supporting team development, and helping ensure a seamless experience for our patients and providers. This position is full‑time, onsite at our Plymouth, MA location. What You’ll Do Resolve complex claim edits, rejections, and denials with accuracy and efficiency Lead advanced A/R follow‑up efforts to ensure timely reimbursement Analyze denial trends and implement proactive solutions Write detailed, effective appeal letters aligned with clinical documentation and payer policies Ensure compliance with timely filing requirements and regulatory standards Review and validate patient demographics, insurance details, charges, and coding Serve as a subject matter expert for billing processes, coding, and payer requirements Collaborate with insurance carriers, patients, physicians, and internal teams to resolve complex inquiries Support accurate eligibility verification, authorizations, and referral processes Review medical records to ensure alignment with medical necessity guidelines Identify workflow improvements to reduce denials and increase efficiency Assist with onboarding, training, and mentoring of new team members What You Bring Strong knowledge of medical terminology, ICD‑10 diagnosis codes, and CPT‑4 procedure codes Advanced understanding of coding modifiers and their appropriate use Several years of experience in medical billing or revenue cycle operations Proven expertise in A/R follow‑up and denial management Deep understanding of insurance eligibility, benefits, and reimbursement processes Familiarity with payer medical necessity requirements and billing policies Excellent communication and customer service skills Strong analytical, organizational, and problem‑solving abilities High attention to detail and accuracy Ability to manage multiple priorities effectively Proficiency with Microsoft Office (Word, Excel, Outlook) Solid understanding of HIPAA regulations College degree preferred CPC, COPC, or similar certification preferred Why Join OCB? At OCB, your work has purpose. Behind every claim you resolve is a patient receiving life‑changing care. We are committed to supporting our employees with opportunities for growth, a team‑oriented culture, and the tools needed to succeed. OCB offers industry leading benefits including: Medical & dental insurance (starts on the 1st day of employment!) 401(k) plan with Company match Company paid Life Insurance Company paid Long Term Disability Eye care discounts Generous Paid Time Off and Paid Holidays To learn more about OCB, please visit our website at #J-18808-Ljbffr