Medical Billing Specialist

Vitreo-Retinal Consultants, Inc. is seeking a Medical Billing Specialist for our Canton location. We are a private practice ophthalmology group that specializes in the retina. We have six fellowship-trained retinal specialists, four main locations, and multiple satellite and surgery centers. We have proudly been serving our communities for 41 years.

Position Summary:
The Billing Specialist will work directly with the Billing Manager. The candidate must possess thorough working knowledge with the skills to independently and appropriately work accounts receivable. This includes the ability to answer billing inquiries from patients and office staff, possess a working knowledge of both the practice management and electronic medical records, have the ability and knowledge to electronically submit claims, post electronic payments and work denied claims appropriately. The billing specialist should have the capability to assist other team members as needed while maintaining their independent responsibilities. Our goal is to ensure that all physicians services are billed in a timely and accurate manner to allow for the highest reimbursement.

Duties and Responsibilities:

• Read and understand explanation of benefits.
• Knowledge of CPT codes, Modifiers, and ICD-10 codes.
• High level understanding of common denials (LCD, NDC, CLIA, bundling, etc.).
• Assure all charges are entered correctly and balance multiple office charges and payments.
• Make necessary changes to patient accounts (address, name, telephone number, and insurance changes, etc.).
• Insurance verification.
• Knowledge of prior authorization process.
• Assure that all electronic and paper claims are sent out timely.
• Review and work claim edits and rejections daily.
• Assist in posting all patient and insurance payments.
• Prepare and send appeals.
• Identify payor related issues and report them to the billing manager
• Answer telephone calls regarding billing inquiries.
• Submit copies of overpaid accounts to billing manager for review.
• Send accounts to collections based on practice policy.
• Assist with setting up patient payment plans.
• Assist in training new employees.
• Maintain strictest confidentiality of patient private health information (PHI) by disclosing only the information requested.
• Perform additional duties as assigned by management.

Qualifications:

• High school graduate or equivalent
• Minimum of 3 years of experience in medical billing
• NextGen experience is a plus.

This job description is intended to provide a basic guideline for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as necessary.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Medical billing: 3 years (Preferred)

Work Location: In person