Billing Specialist

Duties/Responsibilities

• Reviews and processes patient statements for multiple locations.

• Process refund requests and post refunds into the system.

• Reads and interprets insurance Explanations of Payments (EOP) or Explanations of Benefits (EOB) with understanding and can independently take appropriate next steps to resolve issues.

• Posts payments, charge backs, adjustments and remark codes in a timely and accurate manner.

• Research difficult ERAs/EOBs.

• Research open accounts receivables, resolves claims errors and reprocesses claims for successful payment.

• Maintains integrity of patient ledgers, following guidelines provided to manage balances.

• Submits claims electronically and by paper as required. This includes sending secondary claims with attached explanation of benefits.

• Answers incoming questions from patients and clinic team members regarding open account balances and billing issues.

• Ensures compliance with all HIPAA/HITECH requirements as legally required and all applicable federal, state and local regulations.

• Acts as a liaison and provides excellent customer support to teammates in our optometry practices.

• Minimal travel to field practices may be required to meet with peers, develop strong rapport, and understand our business.

• All other duties as assigned.

Required Skills/Abilities 
• Has excellent customer service skills.

• Presents professionally and communicates clearly.

• Embraces and aims for a paperless work environment.

• Demonstrates ability to solve problems and work as a positive member of a team.

• Is technology savvy and appreciates finding new ways to make processes easier.

• Can stay focused on projects and can multi-task when needed.

• Brings his/her best self to work every day and can contribute positively to a team environment.

• Desires a long-term growth opportunity.

Additional Desired Experience 

• Healthcare payment posting • Healthcare insurance and patient collections

• Acuity Logic, Compulink, Eyefinity PM and/or Officemate experience a plus

• Optical billing, Vision Therapy billing, Medicare & Medi-Cal billing experience a plus

Requirements
• Hearing. Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.

• Hand dexterity and eye and hand coordination is critical.

• Lifting. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Use of one or both arms and wrists in lifting files, documents, etc. on a frequent basis.

• Sitting. Must be able to sit for long periods of time.

• Standing. Particularly for sustained periods of time.

• Talking. Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately or quickly.
• Travel as needed between practices.

• Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned or to make general observations of structures. Must be able to read a computer screen for long periods of time.

• Walking. Moving about on foot to accomplish tasks, particularly for long distances or moving from one workstation to another.