Retina & Vitreous of Texas is looking for an energetic medical biller to join our team full-time. The Medical Billing Specialist will be responsible for medical billing, some payment posting, and A/R management.
Ideal candidates will demonstrate a very good understanding of remittances, denials, coding, payer contracts and EOB's as well as prior ophthalmology or retina billing experience.
Responsibilities and Duties
- Post charges, reviewing unusual diagnosis codes, cross-checking procedures with the diagnosis codes, and ensuring proper units are billed.
- Maximize reimbursement through optimum coding, recordkeeping, and follow up.
- Organize and bill electronic insurance claims.
- Devote time weekly to work current rejections. Fix errors and re-bill accordingly.
- Maintain accurate and detailed reports such as Aged Account Receivables.
- Organized work habits, accuracy, and proven attention to detail.
- Work aged accounts on assigned payers prioritizing accounts that are approaching timely filing denial.
- Look up payer eligibility using payer websites/call payers to obtain needed information for billing. Update all accounts in the system for that patient and re-bill.
- Contact guarantors as needed to determine insurance coverage.
- Initiate appeals to payers following the guidelines outlined for the payer. Note account and track appeal to resolution.
- Enter notes on all claims with action taken.
- Provide work status updates to management upon request that may include running statistical reports.
- Answer patient phone calls and assist with billing questions.
- Meet all established deadlines and assigned goals.
- Inform management of any problems or changes with system or payers identified during the course of daily work.
- Understand and follow all payer rules when setting up billing schemes on accounts to ensure accurate claims.
- Understand coding rules and schemes to detect potential claim errors. Consult with supervisor on those accounts in question.
- Ability to work independently but also work effectively with others as a team to accomplish objectives and goals.
- Demonstrated self-motivation, initiative, and time management skills.
- Ability to multi-task and follow schedules.
- Strong organizational, analytical, and interpersonal skills.
- Exceptional written and verbal communication skills.
- Excellent telephone and customer service skills.
- Ability to work within a team setting and as an individual contributor.
Qualifications and Skills
- High School Diploma or Equivalent
- 1-3 years of experience as a Medical Biller or medical billing credentials
- Extensive knowledge of Medicare and other third party procedures, payer websites, ICD-10, CPT coding and claims management.
- Proficiency using software programs such as MS Word, PowerPoint, Excel, Outlook and Electronic Medical Records is preferred.