Ophthalmic Medical Claims Biller

About the position

The Ophthalmic Medical Claims Biller is responsible for processing patient data and managing the billing cycle for medical claims. This role involves ensuring accurate billing, addressing any discrepancies, and communicating with both patients and healthcare providers to resolve billing issues. The position requires attention to detail and the ability to work independently while adhering to established guidelines and policies.

Responsibilities

• Processing patient data
• Posting charges for physicians, including surgeries
• Collecting any missing data from coordinators to send out a correct claim
• Verifying modifiers, ensuring no over coding, and checking authorizations
• Referring to the EMR system for services validation
• Reporting processing to validate charges billed correctly according to guidelines
• Verifying all claims match the number of appointments seen on the date of service billed
• Validating and correcting errors found in the error bucket
• Properly diagnosing phone calls and delivering calls to the appropriate department
• Addressing billing issues and informing the supervisor of any external errors as necessary
• Answering questions from front desk staff and patients regarding their bills
• Informing the supervisor of any billing errors, nonpayment, or denial trends and notifying administration
• Working on delegated reports provided by administration
• Responding to emails and voicemails
• Working on denials, errors, incidents, tasks, and appeals
• Processing billing which includes making phone calls, following up on claim status, and reprocessing claims
• Assessing claim errors found in the error bucket and resubmitting as necessary
• Preparing and submitting billing data and medical claims to insurance companies
• Following policies and procedures

Requirements

• High School Diploma
• Experience using medical billing software
• A bachelor's degree in business, health care administration, accounting or related field is preferred
• Experience working with multi-state Medicaid policies
• Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)
• Strong verbal and written communication skills
• Self-directed with the ability to work with minimal supervision
• Customer service experience
• Proven work experience as a Medical Biller or similar role
• Ability to multitask and manage time effectively
• Outstanding problem-solving and organizational abilities

Nice-to-haves

• Experience with multi-state Medicaid policies
• Bachelor's degree in a related field

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance