Client Success Specialist-REMOTE

Responsibilities

• Build and maintain strong, positive relationships with clients.
• Oversee the filing of medical and/or routine vision claims for assigned clients, ensuring the claims filing team follows established CMS guidelines, standards, and coding requirements.
• Supervise payment posting activities performed by the payment posting team to ensure accuracy and timeliness.
• Manage accounts receivable processes for assigned client accounts.
• Ensure all client claims are submitted, processed, and followed up on in a timely manner.
• Monitor claim accuracy and compliance, ensuring appropriate coding (ICD-10, CPT, and HCPCS) is utilized to maximize reimbursement.
• Identify and resolve billing, reimbursement, and claims-related issues while maintaining high levels of client satisfaction.

Qualifications

• Working knowledge of CPT, ICD-10, and HCPCS coding.
• Experience with vision plan claim filing and reimbursement processes.
• Ability to read, understand, and accurately interpret billing regulations and payer guidelines.
• Ability to review and interpret insurance Explanation of Benefits (EOBs).
• Strong attention to detail with excellent analytical and organizational skills.
• Proven ability to identify, research, evaluate, and resolve complex billing and claims issues.
• Self-starter with strong time management skills and the ability to prioritize, multitask, and work independently.
• Excellent verbal and written communication skills, with a strong customer service focus.
• Professional, dependable, and collaborative team player.
• Proficient in internet-based research and navigating web-based systems.
• Adaptable and willing to learn new software platforms and technologies.

Preferred Qualifications

• Self-motivated with the ability to work effectively with minimal supervision.
• Experience in optometric and/or ophthalmic billing; industry certification is preferred but not required.
• Experience with one or more of the following practice management systems: Compulink, OfficeMate, RevolutionEHR, Crystal PM, EPM, MVE, Uprise, Practice Director, Barti, Liquid EHR or EyeCloud Pro.
• Experience working with clearinghouses and payer portals, including TriZetto/Gateway EDI, Apex EDI, ZirMed, VisionWeb, Availity, and Eyefinity.