Medical Biller / Insurance Verification Specialist - Optometry

Our NYC-based optometry practice is seeking a detail-oriented, remote Insurance Verification Specialist to manage eligibility and benefits for approximately 80 patients per week. This role is critical to our daily operations, ensuring that patient responsibilities are accurate before they step foot in our office. You will be a key part of our administrative team, communicating primarily via Slack.

Key Responsibilities:

• Perform full verification for 80+ patients weekly, covering both Vision (VSP, EyeMed, etc.) and Medical plans (Medicare, Medicaid, etc.).
• Accurately pull and document deductibles, copays, and co-insurance for both routine and medical eye exams.
• Order and verify insurance from primary, secondary, and tertiary payers.
• Proactively identify plans requiring referrals and contact PCPs to secure necessary authorizations timely.
• Reach out to patients via phone/email if insurance information is missing or inactive.
• Provide real-time updates to office staff via Slack regarding patient eligibility status.

Required Qualifications:

• Minimum 2 years of experience in Insurance Verification specifically within Optometry or Ophthalmology.
• Proficiency with VSP (Eyefinity), EyeMed, Medicare, Availity, Trizetto and NY Medicaid portals.
• Comfortable using Slack for team communication and Eyecloud Pro EHR.
• Ability to distinguish between vision and medical coverage based on patient visit reasons.
• Self-motivated and capable of completing workload by established deadlines in a remote setting.

Schedule:

• Approximately 8-12 hours per week with flexible hours.
• All verifications must be completed at least 48 hours prior to the patient's appointment.