Ophthalmic Billing Specialist

Eugene Eye Care Associates Pc-posted about 1 year ago
$39,520 - $49,920/Yr
Full-time • Entry Level
Springfield, OR
Ambulatory Health Care Services
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The Ophthalmic Billing Specialist at Eugene Eye Care Associates is responsible for managing the billing processes related to ophthalmic services. This role involves ensuring the accuracy of patient bills, processing claims, and reconciling patient accounts to facilitate smooth reimbursements. The specialist will also handle patient inquiries and assist with payment plans, while staying updated on relevant coding and insurance regulations.

  • Review patient bills to ensure the accuracy and completeness of the information.
  • Process claims promptly to ensure reimbursements for services provided.
  • Reconcile patient claims to ensure smooth auto-flow for EHR to PMS for electronic claims.
  • Submit all patient visits and surgeries to payers.
  • Actively work any claim rejections in the clearinghouse and submit claims.
  • Review pending claims within 30 days to determine if the claim will be denied.
  • Work with physicians and clinical staff to select appropriate CPT codes for billing.
  • Transfer appropriate balances to patient responsibility.
  • Use the PMS workflow module to manage denials and follow-up on unpaid claims.
  • Ensure PMS auto-generates patient statements and assist patients with payment plans when needed.
  • Download electronic EOBs and post payments when received.
  • Respond to billing phone calls and questions.
  • Attend Ophthalmic billing and coding conferences as the practice assigns, virtually or in person.
  • High school diploma or equivalent.
  • Familiarity with ICD-10 coding, CPT codes, and HCPCS codes.
  • Understanding of Medicare, Medicaid, and private insurance policies.
  • A firm grasp on medical billing procedures.
  • Ability to stay current with changing Medicare and private insurance healthcare regulations and trends.
  • Command of coding and data entry processes.
  • Ability to handle patient phone calls compassionately and efficiently.
  • Ability to work efficiently, stay organized, and meet deadlines.
  • Demonstrated ability to work well with co-workers.
  • Ophthalmic certifications such as an Ophthalmic Coding Specialist (OCS) are a plus.
  • 401(k)
  • 401(k) matching
  • Employee discount
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance
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