- Responsible for billing, charge entry, payment posting, eligibility, coverage, patient collections, and overpayment resolution.
- Contact payers for appeals, documentation needs, reconsiderations, adjustments, claim corrections and any other activity that pertains to resolution of claim issues.
- Complete follow-up of patient accounts to maximize reimbursement.
- Monitor and execute work on assigned claim worklists, AR worklists.
- Ensure that all patient information is accurate and complete and request any missing patient information.
- Interact with physicians to obtain billing and documentation clarification.
- Resolve posting issues, manage remittance and all correspondence.
- Illustrate excellent knowledge of healthcare industry regarding the revenue cycle, coding, and claim processing.
- Strong attention to detail, commitment to service, and ability to follow through on assigned responsibilities.
- Work effectively with others and as a team member.
- Answer patient inquiries regarding account status professionally, accurately, and timely; Maintain HIPAA confidentiality of patients.
- Complete other duties/projects as assigned to help support the overall billing function.
- 5+ years of billing and/or medical collections experience or equivalent accounting experience; Prior ophthalmic or optometric medical billing experience
- Knowledge of principles and practices of medical billing and ICD-10
- Ability to communicate clearly and professionally to patients over the phone.
- Ability to effectively interpret and post various payer EOB payments.
- Enthusiasm and patient relationship focused - must be able to work with patients on the phone to resolve payment issues in a mutually satisfactory manner.
- Proven dependability and reliability.
- Organization in how you go about your work, able to multi-task when needed.
- Discretion and professionalism - which is expected due to the exposure to sensitive operational and financial information.
- Self-motivation and flexibility to handle tasks as they arise in addition to those already scheduled.
- Demonstrated skills in problem solving, time management, and adaptability to a changing environment.
- Computer literacy and strong keyboarding skills
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Description
As a Medical Billing Specialist - Accounts Receivable, you will be responsible for the insurance billing and collections function for an Ophthalmology practice consisting of 10 doctors. A key aspect of this role is to prioritize and manage patient financial obligations efficiently. Your success in this position will be driven by your ability to complete billing and/or accounts receivable follow-up while achieving the expected quality and productivity requirements.
Essential Responsibilities: