Medical Billing and Coding Specialist

Retina and Vitreous of Texas, PLLC - Houston, TX
Posted: August 13, 2019

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.

 


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Retina and Vitreous of Texas, PLLC

Retina and Vitreous of Texas, PLLC

Houston, TX

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