Medical Billing Specialist

Benefits include 401(k) with matching, dental insurance, health insurance, paid time off, training and development, and vision insurance.

The Billing Specialist is responsible for posting insurance payments, entering charges, and assisting patients with their accounts. This position requires accuracy, thoroughness, and a strong understanding of insurance processes such as referrals, co-pays, deductibles, allowable charges, CPT and Dx codes.

Key responsibilities include maintaining patient confidentiality according to HIPAA, verifying claim accuracy before submission aiming for zero errors, reviewing claims and denials to ensure maximum reimbursement, and following up on unpaid claims over 30 days. The specialist also reviews referrals and authorizations, responds to inquiries and complaints from patients or insurance companies, researches and appeals denied claims, and reads and interprets insurance explanations of benefits.

Additional duties include reporting to executive director and billing supervisor, initiating late payment notices, identifying and billing secondary/third-party insurances, following billing regulations set by Medicare, state programs, and HMO/PPO, ensuring patient information accuracy, managing documentation, collecting delinquent accounts, and meeting departmental goals and metrics.

The employee is expected to become OCSR (Ophthalmic Coding Specialist - Retina) certified within the first 6 months; all costs covered.

Physical requirements include prolonged periods at a desk and ability to lift up to 15 pounds.