Medical and Vision Claims Billing Specialist

Overview
Join our team as a Medical and Vision Claims Billing Specialist, where your expertise will drive accurate and efficient processing of medical and vision insurance claims. In this vital role, you will ensure that claims are submitted correctly, follow up on outstanding payments, and collaborate with providers and insurance companies to resolve billing issues. Your attention to detail and knowledge of medical coding and billing procedures will directly impact the financial health of our organization and the satisfaction of our patients. This position offers an energetic environment where proactive problem-solving and clear communication are celebrated.

Duties

• Review and interpret medical records, ensuring all documentation aligns with billing requirements and coding standards.
• Assign appropriate diagnosis codes using ICD-10, CPT (Current Procedural Terminology), and DRG (Diagnosis-Related Group) classifications to facilitate accurate claim submissions.
• Prepare and submit clean claims for medical and vision services via Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems, adhering to payer guidelines.
• Follow up on unpaid or denied claims promptly, initiating appeals or resubmissions as needed to maximize reimbursement.
• Collaborate with healthcare providers to clarify billing details, verify patient insurance coverage, and update medical records accurately.
• Maintain comprehensive records of all billing activities, claim statuses, and correspondence in secure systems.
• Stay current with industry regulations, coding updates, and insurance policies to ensure compliance and optimize claim processing efficiency.
• Billing patients for balances due and accounts receivable.

Experience

• Proven experience in medical billing with a focus on claims processing for both medical and vision services.
• Strong knowledge of medical terminology, medical records management, and coding standards including ICD-10, CPT coding, DRG classifications, and medical coding best practices.
• Familiarity with EMR/EHR systems used for billing and record keeping.
• Demonstrated ability to navigate insurance claim processes efficiently while maintaining high accuracy levels.
• Excellent communication skills for interacting with healthcare providers, insurance representatives, and patients.
• Prior experience in a fast-paced medical office environment is preferred but not required. Join us to be part of a passionate team dedicated to delivering exceptional healthcare billing services! Your expertise will help ensure smooth financial operations while supporting our mission to provide outstanding patient care through precise billing practices.

Pay: $19.00 - $21.00 per hour

Expected hours: 35.0 – 37.0 per week

Benefits:

• Paid time off

Work Location: In person