Lakeland Eye Clinic - Lakeland, FL

posted about 1 month ago

Full-time - Entry Level
Lakeland, FL
Ambulatory Health Care Services

About the position

The Billing Specialist at Lakeland Eye Clinic is responsible for managing the billing process, including preparing, reviewing, and transmitting claims. This role requires a high degree of professionalism, excellent communication skills, and the ability to work independently. The specialist will handle insurance claim denials, verify payments, and ensure compliance with billing procedures while maintaining accurate records and addressing patient inquiries.

Responsibilities

  • Prepare, review, and transmit claims using billing software including electronic, website submission, and paper claim processing.
  • Status unpaid claims within standard billing cycle timeframe.
  • Timely review/handling of insurance claim denials, exceptions, or exclusions.
  • Forwards requests for medical records to appropriate internal resources.
  • Addresses/corrects demographic information requested by insurance company.
  • Ability to read and accurately interpret insurance Explanation of Benefits (EOB's).
  • Verifying insurance payments for accuracy/compliance based on contracts to ensure correct reimbursement is received.
  • Following up directly with insurance companies regarding payment discrepancies.
  • Utilizing aging reports and work flow statuses provided by Supervisor to address any unpaid or open claims over 30, 60, 90, and 120 plus.
  • Coordination of Benefits (COB) - Ability to identify and bill secondary or tertiary.
  • Documenting denials associated with Patient responsibility to forward to the collection team.
  • Ability to research and appeal denied claims.
  • Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
  • Report payment discrepancies or denial trends identified to Supervisor as soon as they are identified for assigned accounts.
  • Perform additional duties as requested by Supervisor or Upper Management Team.

Requirements

  • Proven experience as a Collection Specialist or similar role for 2+ years.
  • Minimum High School Diploma.
  • Experience with CPT and ICD-9/10; Familiarity with medical terminology.
  • Knowledge of billing procedures and collection techniques.
  • Computer experience is essential, including practice management software, clearing houses, MS Office, and spreadsheet applications.
  • Strong written and verbal communication skills.
  • Detail-oriented with consistent production results.
  • Good problem solving and research skills.
  • Able to multi-task and meet deadlines.
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