Centralized Insurance Specialist-Ophthalmology

Job Title: Centralized Insurance Specialist – Ophthalmology

Coastal Eye Group is a leading provider of comprehensive eye care services. Our dedicated team of professionals is committed to delivering the highest quality of care to our patients. We are currently seeking a detail-oriented and experienced Centralized Insurance Specialist to join our administrative team.

Job Description:

The Centralized Insurance Specialist will be responsible for managing all aspects of insurance billing and claims processing for our ophthalmology practice. This includes verifying patient insurance coverage, submitting claims, and following up on unpaid claims. The ideal candidate will have a strong understanding of insurance procedures and ophthalmology-related billing codes.

Key Responsibilities:

• Verify patient insurance coverage and eligibility.
• Submit insurance claims accurately and in a timely manner.
• Follow up on unpaid or denied claims to ensure prompt resolution.
• Communicate with insurance companies, patients, and clinical staff to resolve billing issues.
• Maintain detailed records of insurance claims and payments.
• Assist patients with insurance-related inquiries and provide information on coverage and benefits.
• Stay current with changes in insurance regulations and policies, particularly those relevant to ophthalmology.
• Work collaboratively with other members of the administrative team to streamline billing processes.
• Audit accounts in PM & EHR to ensure detailed notes are entered regarding patient coverage and authorization status.
• EFT management.
• Oversee chart audits.
• Manage AR, denials, appeals.
• Oversee payments

Qualifications:

• High school diploma or equivalent
• Strong knowledge of medical billing software and electronic health records (EHR) systems.
• Familiarity with CPT and ICD-10 codes specific to ophthalmology preferred.
• Excellent communication and customer service skills.
• High attention to detail and strong organizational abilities.
• Ability to work independently and manage multiple tasks simultaneously.

Benefits:

• Competitive salary commensurate with experience.
• Comprehensive health, dental, and vision insurance.
• Paid time off (PTO) and holidays.
• Retirement savings plan with employer match.
• Friendly and collaborative work environment.

Job Type: Full-time

Pay: $15.00 - $23.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Ability to Commute:

• Little River, SC (Required)

Ability to Relocate:

• Little River, SC: Relocate before starting work (Required)

Work Location: In person