Charge Entry and Auditing Specialist

Ophthalmology Or Optometry AR Follow-Up Specialist

Evenflow Solutions has a client that is looking to add a remote Ophthalmology or Optometry AR Follow-Up specialist to their team. This is a direct hire position with our client that offers a generous benefits package and a great working environment.

Direct hire position

This will be a 100% remote position

Must have at least 3 years of experience in Optometry or Ophthalmology

Overview of Position: A/R Specialist is responsible for calling all insurance companies and utilizing online resources to check claim status, resubmit claims as necessary via paper or electronically, file appeals, track denial trending, resolve denials, and ensure maximum revenue capture. In addition, this role will facilitate the timely receipt of payments and ensure balances on accounts are correct and appropriately prorated.

Job Duties and Expected Performances:

• Key charges for office visits, minor procedures, hospital billing, and surgery charges following standard guidelines for coding and billing.
• Post charges, reviewing diagnosis code and cross-checking with the procedure code.
• Review encounters via Practice Management System, reports, and other sources with an average productivity of 50 accounts per day.
• Document follow-up appropriately in the practice management system.
• Maintain an acceptable error rate and productivity level within department policy.
• Perform collection actions, including third-party appeals and resubmitting claims to third party payers.
• Identify and bill secondary or tertiary insurances.
• Reconcile carrier submissions, edits, and rejection reports.
• Resolve incoming patient calls with excellent customer service skills.
• Employ tactfulness in dealing with insurance companies/patients regarding accounts in verbal and written communication, while being professional and courteous at all times.
• Identify, verify, and document adjustments according to established policies and procedures.
• Research and prepare credits for refund approval.

Required:

• High School Graduate or General Education Degree (GED)
• At least 3 years of experience in Optometry and Ophthalmology billing and Follow-Up

Experience:

• Experience with Nextgen PM/HER
• At least 5 years of professional medical billing and collecting experience, or certification obtained from a nationally accredited billing program, i.e., CMBS (Certified Medical Billing Specialist).
• Must have experience with Appeals and Denials process
• Experience Following up with Insurance companies on claims
• Experience with Excel and Windows-based programs.
• Experience in performing tasks that require a basic understanding of accounting and math skills.

Evenflow Solutions (ES) is an Equal Opportunity Employer. ES provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.