Billing Coordinator

Billing Specialist

The Billing Specialist will play a vital role in the financial operations of our ophthalmology practice, ensuring that claims are processed efficiently and patient billing inquiries are handled with care. The role encompasses a range of tasks within the billing department, including medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, reimbursement management, and authorization management.

Reports to: Revenue Cycle Manager

Key Responsibilities:

• Claims Management:


• Work on accounts receivable (A/R), process rejected claims, and perform necessary follow-up to ensure successful claim processing.


• Follow up on claims using various systems, including Nextech EHR, TriZetto clearinghouse, and others.


• Prepare and submit clean claims to insurance companies electronically or by paper.


• Correct and resubmit claims to third-party payers when needed.


• Mail appropriate patient contact letters to resolve outstanding claims.

Billing Operations:

• Maintain contact with other departments to obtain and analyze patient information for accurate billing documentation.


• Respond to patient inquiries and billing concerns via phone, email, and messaging portals.


• Perform follow-up calls and written correspondence to patients and payers as needed.


• Prepare, review, and send patient statements as necessary.

Authorization Management:

• Obtain and verify insurance authorizations and pre-certifications for procedures and services.


• Ensure all necessary authorizations are secured prior to patient appointments and procedures.


• Track authorization expirations and follow up on renewals as needed.


• Communicate with patients and insurance companies to resolve authorization issues or delays.

Customer Service & Compliance:

• Identify and resolve patient billing complaints in a timely manner.


• Adhere to policies regarding safety, confidentiality, and HIPAA guidelines.


• Establish and maintain effective working relationships with office staff and doctors, ensuring a collaborative work environment.

Qualifications and Requirements:

• Minimum of 2+ years of experience in ophthalmology billing.


• Knowledge of medical terminology specific to ophthalmology.


• Proficiency in CPT, HCPCS, and ICD codes related to ophthalmology.


• High school diploma required; an associate degree is preferred.

Skills:

• Ability to work independently with minimal supervision.


• Strong organizational and time management skills.


• Detail-oriented with the ability to manage multiple tasks and meet deadlines.


• Strong communication skills, with the ability to effectively interact with patients and office staff.


• Resourceful, result-driven, and a team player.

Work Environment:

• Hybrid position with the ability to be on-site for meetings, training, or other work-related functions.


• Monday through Friday, 8:00 AM to 5:00 PM.

Compensation Range: $23.00 – $28.00 per hour.

Note: The content of this job description is intended to provide a general overview of the job's key responsibilities and qualifications. Additional responsibilities may be assigned to meet practice needs.

Job Type: Full-time

Pay: $23.00 - $28.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)


• 401(k) matching


• Dental insurance


• Employee assistance program


• Health insurance


• Life insurance


• Paid time off


• Tuition reimbursement


• Vision insurance

Schedule:

• 8 hour shift


• Day shift


• Monday to Friday

Experience:

• ICD-10: 2 years (Required)

Ability to Commute:

• Poway, CA (Required)

Work Location: Hybrid