A growing ophthalmology organization is expanding its revenue cycle team due to the acquisition of new specialty practices. The organization is seeking an experienced Medical Billing Specialist with a strong background in retina revenue cycle management to support insurance billing, accounts receivable follow-up, and denial resolution.

This role is focused on insurance claims and physician billing and does not involve patient collections or payment arrangements.

Key responsibilities include:

Manage insurance accounts receivable follow-up for physician claims
Research and resolve denied or underpaid claims
Prepare and submit appeals and corrected claims
Review claims for billing accuracy before submission
Process claim edits, payment posting, and limited charge entry
Work with commercial and government payers, including Medicare
Collaborate with internal billing teams to ensure accurate claim processing
Maintain productivity while meeting quality and accuracy standards
Support revenue cycle operations across multiple specialty practices

Requirements & Qualifications

At least 1 year of retina billing experience
Strong knowledge of retina-specific J-codes
Medical billing modifiers
Drug billing and reimbursement
Experience with professional (physician) claims
Knowledge of accounts receivable follow-up and denial management
Experience working with Medicare and commercial insurance plans
Strong attention to detail and problem-solving skills
Experience with Nextech, NextGen, or similar practice management systems preferred
Knowledge of charge entry and payment posting preferred
Experience with specialty ophthalmology or retina practices preferred

Benefits & Perks

Medical insurance
Dental insurance
Vision insurance
401(k)

Retina Billing Specialist