Medical Billing/Coding Specialist

Description:

Job title

Medical Billing/Claims Submission

Reports to

Billing Manager

Summary of Responsibilities

Our ophthalmology clinic is seeking a detail-oriented Medical Billing Specialist with a strong focus on claim submission and clean claim processing. This position is responsible for preparing, reviewing, and submitting accurate claims to insurance carriers to ensure timely reimbursement and minimal denials.

The ideal candidate understands ophthalmology coding, modifiers, surgical billing, and insurance guidelines to prevent claim rejections before submission.

Essential Functions:

• Prepare and submit electronic claims through clearinghouse systems
  
• Review claims for accuracy (CPT, ICD-10, HCPCS, modifiers, demographics, authorizations)
  
• Ensure proper coding for ophthalmology procedures and diagnostic testing
  
• Submit surgical and office visit claims in compliance with payer guidelines
  
• Identify and correct claim errors prior to submission
  
• Monitor claim rejections and resolve front-end issues promptly
  
• Verify insurance eligibility and authorization requirements
  
• Work closely with providers and coding staff to clarify documentation
  
• Maintain compliance with Medicare, Medicaid, and commercial payer regulations

Requirements:

Minimum Education Requirements

• High school diploma or GED.
• Good verbal communication skills.

Minimum Background Requirements

• 1-3+ years of medical practice billing required
• 1+ years’ experience as medical or ophthalmic billing specialist required
• 1-3+ years’ experience with ICD-10 and CPT coding
• Skill in computation, typing and filing.
• Ability to make simple mathematical computations.

Preferred Education and Experience

• Certified Biller/Coder

Affirmative Action/EEO statement

Louisiana Eye and Laser’s practice is to comply with all federal, state and local employment law, and it is committed to equal opportunity in employment. LEL is committed to providing equal opportunity for all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, political affiliation, veteran status, membership or application for membership in a uniformed service such as the military or a public health service, genetic information or any other characteristic protected under federal, state, or local law.

Other duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.