Claims Processor - Administration

Florida Eye Specialists is a top provider in eye care for the greater Jacksonville area and is the preferred provider for the Jacksonville Jaguars! There are currently ten locations in and around Jacksonville and we are growing every day! The physicians and staff of Florida Eye Specialists are united by a common passion for excellence in eye care. Our doctors have dedicated numerous years of medical school, residency, fellowship and post-fellowship training to eye-disease research and education.
LOCATION :On site/Florida Eye Specialists Administration Office
Job Summary:
The Claims Analyst is responsible for reviewing, correcting, and resubmitting insurance claims to maximize reimbursement and ensure timely and accurate payment. This position will also be responsible for insurance pre-payment medical record review and submission, claims reconsiderations, and follow-up with insurance carriers regarding outstanding or denied claims.
Duties/Responsibilities:
Resubmission of unpaid claims; claims follow-up
Response to billing phone calls and questions,internaland external
Daily charge entry
Authorizations forurgent and non-urgent in-office and outpatient services
Obtain, verify and enter accurate patient insurance policy information
Contacts insurance companies via portal or phone requesting policy and coverage limits, deductible amounts, and any pre-existing clauses on all surgeries or when coverage is in question
Collect and post patient payment
Comply with HIPAA confidentiality standards when accessing or communicating patient information
Other duties as assigned by supervisor, manager or physician
Required Skills/Abilities: Working knowledge of medical insurance claims, including claim denials and resolution
Working knowledge of CPT, HCPC, and ICD-10 codes
Basic understanding of Medical Terminology (preferably ophthalmology)
Excellent verbal and written communication skills
Ability to interact with insurance companies, patients and employees in a courteous, professional manner at all times
Excellent organizational skills and attention to detail
Strong problem-solving and investigative skills
Ability to multi-task and function well in a high-paced and at times stressful environment
Comply with HIPAA confidentiality standards when accessing or communicating patient information

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