Ophthalmology Billing & Coding

Seeking full time Medical Biller/Coder for busy multispecialty ophthalmology office.

Medical Biller/Coder/Collector is responsible for timely submission of Ambulatory Surgical Center and Professional claims to Insurance companies from a wide variety of medical providers and facilities, as well as monitoring and ensuring that payments for medical services are received in a timely manner and that prior authorizations have been obtained if necessary. Medical/Coder/Biller will also function as an intermediary between Healthcare providers, clients and health Insurance companies and must also be able and willing to work directly with Doctors and staff concerning any billing and coding discrepancies, updates and changes.

Essential Functions

· Fast paced, multiple provider and location Practice with Ambulatory Surgical Centers at each location.

· Current knowledge of ICD10 and CPT coding

· Review patient bills for accuracy and completeness, obtain missing information.

· Knowledge of wide range of Insurances and their individual rules and guidelines.

· Identify Insurance Company or proper party (patient) to be billed, identify and bill all secondary and tertiary Insurances.

· Perform coding and billing tasks on a computerized health information technology (HIT) system.

· Utilize a combination of electronic health record (EMR) and paper patient records to perform billing, coding and collection duties; maintain an accurate, legally compliant medical record.

· Process claims as they are paid and credit accounts accordingly.

· Provide Prior authorizations/ Pre determinations for planned and emergent procedures; in house and at outside Facilities.

· Review denials or partially paid claims and work with the involved parties to resolve payment discrepancies.

· Manage assigned accounts ensuring outstanding claims are paid in a timely manner and contact appropriate parties to collect payment with detailed documentation of process to facilitate understanding of your accounts with other staff members.

· Communicate with health care providers, staff, patient, insurance claim representatives and other parties to clarify billing issues and rule changes/updates.

· Consult supervisor, team members and appropriate resources to solve billing and collection questions and issues.

· Participate in maintenance of acquiring and updating Fee schedule changes, Financials and ABN’s.

· Maintain work operations and quality by following standards, policies and procedures, escalate compliance issues to supervisor.

· Perform a variety of Administrative duties including but not limited to: answering phones, faxing and filing of confidential documents; and basic internet and Email utilization.

· Provide excellent and professional customer service to Internal and external customers.

· Function as a contributing team member while meeting deadlines, productivity standards and constant changes in Insurance and In house rules, requirements and regulations.

Minimum Requirements

· Education: High school Diploma or equivalent.

· Training and experience: minimum of one year of current experience within the last three years in a comparable job classification preferred.

· Internet, email and data entry skills required.

· Ability to work effectively within role independently and with other team members.

· Organizational and prioritizing skills to complete work in a timely manner

Benefits

· Benefit package provided including vacation, sick leave, 401K and pension.

· Group Health Insurance.

· Pay commensurate to training and experience.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off

Work Location: In person