What are the responsibilities and job description for the Medical Billing Specialist - Ophthalmology position at Simon Eye Associates?
Simon Eye and the Center for Advanced Eye Care are partner Ophthalmology and Optometry practices with a combined 28 providers and 110 staff serving northern and southern Delaware. We are aligned to ensure our communities can access patient-centered, medically oriented full service eyecare delivered in convenient locations with friendly, knowledgeable doctors and staff.
As a Medical Billing Specialist - Ophthalmology, you will be responsible for the insurance billing and payment posting process for our Ophthalmology practice. Your success in this position will be driven by your ability to complete billing and/or accounts receivable follow-up with payers while achieving the expected quality and productivity requirements.
What You’ll Do:
- Process and submit accurate and timely claims to payers, analyze and research unpaid claims, and assist in the resolution of denials, partial payments, and payment variances.
- Determine patient eligibility along with basic benefit verification (qualifying diagnoses and authorization requirements.
- Identify payer trends and/or issues and escalate for leadership consideration along with possible solutions.
- Consistently work payer denials and rebill claims as needed.
- Ensure the timely and accurate resolution of outstanding invoices either through cash collections or adjustments.
- Answer patient inquiries regarding account status professionally, accurately, and timely; Maintain HIPAA confidentiality of patients.
- Complete other duties/projects as assigned to help support the overall billing team.
What You’ll Need:
- 2+ years of billing and/or medical collections experience or equivalent accounting experience
- Prior experience working in an EHR system
- Knowledge of principles and practices of medical billing and ICD-9/10
- Knowledge of claim and benefit requirements for Medicare, Medicaid, HMO, PPO and/or other third party payors.
- Ability to calculate figures and amounts correctly
- Ability to communicate clearly and professionally to patients over the phone.
- Strong troubleshooting skills - ability to anticipate issues, research and implement creative solutions.
- Enthusiasm and patient relationship focused – must be able to work with patients on the phone to resolve payment issues in a mutually satisfactory manner.
- Proven dependability and reliability.
- Superb organizational skills; able to multi-task when needed & with limited supervision.
- Discretion and professionalism - which is expected due to the exposure to sensitive operational and financial information
- Self-motivation and flexibility to handle tasks as they arise in addition to those already scheduled with adherence to deadlines.
- Demonstrated skills in problem solving, time management, and adaptable to a changing environment.
- Computer literacy and strong keyboarding skills
