Billing Invoicing Processor

Billing Invoicing Processor

Work hours: 8am-5pm M-F Start date: ASAP Length of assignment: 6 months Location Address: Mason, OH Hybrid - 2-3x a week.

Specific Skills Needed: Top 3-5 mandatory and/or minimum requirements:

• Knowledge of Medical Terminology: Understanding medical terms related to vision care.
• Understanding of Insurance and Billing Procedures: Familiarity with different insurance plans, billing processes, and coding systems (e.g., ICD-10, CPT).
• Attention to Detail: Ensuring accuracy in billing, coding, and documentation.

Top 3-5 desirable attributes/qualifications:

• Computer Proficiency: Ability to use billing software, electronic health records (EHR), and other healthcare management systems.
• Communication Skills: Effective communication with healthcare providers, insurance companies, and patients.
• Problem-Solving Skills: Ability to handle billing discrepancies and insurance claim denials.

Required levels/ Years of Experience education discuss whether there is flexibility Bachelor's Degree + 3 years of experience OR 5+ years of experience.

Major Duties and Responsibilities:

• Interfaces daily with internal and external clients (via phone and email) to research and resolve issues accurately and in a timely manner, escalating where necessary.
• Ensures timely communication to internal and external stakeholders and provides status updates to management.
• Develops and delivers reporting and analyzes data to identify trends, provide forecasts, make recommendations, and offer solutions to facilitate accurate invoicing of premiums and/or claims to internal stakeholders and external clients.
• Analyzes and delivers insight on invoicing trends, including billing frequency and root cause analysis (i.e. revenue entities, client set-up issues, retro adjustments, membership, rates, etc.).
• Facilitates accurate invoicing by identifying high risk clients and validating billing process.
• Identifies and recommends system/process modifications to improve efficiency and effectiveness.
• Determines and initiates requests for account holds & retro billing.
• Audits new or modified set-ups to ensure accurate invoicing and data transfers.
• Acts as the subject matter expert for billing and invoicing as the main contributor to effective billing process and client migration related projects and activities.
• Leads and conducts all billing and invoice related training as necessary, including the training and communication of changes in business processes.

Qualifications/Preferred Experience:

• Knowledge of Medical Terminology: Understanding medical terms related to vision care.
• Understanding of Insurance and Billing Procedures: Familiarity with different insurance plans, billing processes, and coding systems (e.g., ICD-10, CPT).
• Attention to Detail: Ensuring accuracy in billing, coding, and documentation.
• Computer Proficiency: Ability to use billing software, electronic health records (EHR), and other healthcare management systems.
• Communication Skills: Effective communication with healthcare providers, insurance companies, and patients.
• Problem-Solving Skills: Ability to handle billing discrepancies and insurance claim denials.
• On-the-Job Training or Internship: Practical experience through entry-level positions in medical billing.
• Experience in Vision Care Settings: Specific experience in ophthalmology or optometry practices is advantageous.
• Understanding of privacy and security regulations.