Billing Specialist (4722C) Optometry Clinic, 73955

$61,630 - $70,637/Yr

University of California - Berkeley, CA

Full-time - Entry Level

Berkeley, CA

101-250 employees

Educational Services

About the position

The Billing Specialist at the University of California, Berkeley's Optometry Clinic is responsible for managing patient billing and collections activities. This role involves preparing and submitting insurance claims, processing payments, and resolving billing issues to ensure accurate and timely reimbursement for services provided. The specialist will work closely with various stakeholders, including patients, insurance providers, and clinic administration, to maintain efficient billing operations and uphold compliance with relevant regulations.

Responsibilities

• Prepare and submit insurance claims to medical and vision insurance providers.
• Assist in verifying completeness and accuracy of charge captured information.
• Generate and scrub claims using the Practice Management System.
• Review claims transaction reports to capture details related to denials.
• Identify and correct denials, alerting Clinic Administration or IT of chronic issues.
• Resolve issues related to rejected claims and rebill as necessary.
• Monitor unpaid claims and follow up with insurance carriers to ensure payment.
• Conduct follow-up on accounts and evaluate appropriate follow-up actions.
• Communicate effectively with payers, patients, and clinic staff regarding billing issues.
• Prepare appeal letters to payers requesting additional payment and retrieve necessary information to support appeals.
• Reconcile cash, checks, and credit card payments from the previous day.

Requirements

• Thorough knowledge in administrative procedures and processes including word processing, spreadsheet and database applications.
• Good verbal and written communication skills, active listening, critical thinking, multi-tasking, and time management skills.
• Previous work experience that required knowledge of physician billing procedures including charge entry, payment posting, and claim follow-up.
• Full knowledge of ICD-10, CPT, HCPCS, and EHR experience with platforms such as Compulink Advantage and Epic.
• Experience with insurance verification, authorization, claim submission, and follow-up processes.
• Understanding of Medi-Cal, Blue View Vision, Private insurance, VSP, and payment policies.

Nice-to-haves

• Experience in a higher education environment.
• Familiarity with HIPAA compliance and security regulations.

Benefits

• Vision insurance
• Paid time for professional development activities (80 hours per year)