Busy ophthalmology practice focused on excellence in patient care and creating exceptional patient experiences seeking experienced Ophthalmology/Optometry Billing Specialist. We offer great pay and benefits in an exceptional team work environmeny/ Exciting opportunity! M-F, days, EOE. - Proficient in billing claims from EHR (Nextech PM experience, a plus!), downloading and posting EFTs from Clearinghouse, claim research and resolution, refund requests, filing appeals, A/R follow-up.
- Uses eligibility tools, and is capable of checking benefits through Availity, UHC Provider/Humana Military and other payer websites.
- Experience in filing Routine claims and obtaining routine eye benefit authorizations.
- Contacts insurance carriers to verify coverage and limits as directed by policy.
- Initiates financial agreements for high-deductible health plans and co-insurances.
- Obtains appropriate prior authorizations relevant to date of service and procedure, including same day/add-on procedures, surgeries and testing.
- Contacts patients regarding balance due at time of service, and effectively communicates insurance coverage limits to patients.
- Documents all communication with patients in Practice Management system.
- Provides coverage for Front Desk, as needed.
- Participate fully as a team member in a dynamic, patient-focused, fast-paced environment.
- Researches accounts, and resolves claim issues.
- Participates and assists in in-house collection projects, as assigned.
- Participates and assists in special billing projects, as assigned.
Required Skills & Abilities: - Experience in insurance eligibility, prior authorizations and referrals in a health care setting.
- Knowledgeable in use of Availity, UHC Provider/Humana Military websites.
- Knowledgeable of CPT/ICD-10 coding; ophthalmology experience, a plus.
- Detail-oriented with excellent organizational and time management skills.
- Excellent communication skills, both verbal and written.
- Proficiency with Microsoft Word and Excel.
- Positive attitude and demeanor.
- Ability to work in a fast-paced environment.
- Experience using a PM and EHR system (Nextech/IntelleChart,a plus!).
- Must be able to pass background and drug screening.
Excellent benefit package to include PTO, health/dental insurance, 401k. Outstanding work environment. Salary commensurate with experience.
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