BILLING SPECIALIST
Openings: 3
Industry: Medical / Healthcare
Location: Mission Viejo, CA
POSITION REQUIREMENTS:
- High School diploma or General Education Degree (GED)
- Healthcare billing experience
- Strong typing and data entry skills including 10-key
- Basic knowledge of Microsoft products including Excel, Word, and Outlook
CORE DUTIES AND RESPONSIBILITIES:
- Reviews and processes patient statements for multiple locations.
- Process refund requests and post refunds into the system.
- Reads and interprets insurance Explanations of Payments (EOP) or Explanations of Benefits (EOB) with understanding and can independently take appropriate next steps to resolve issues.
- Posts payments, charge backs, adjustments and remark codes in a timely and accurate manner.
- Research difficult ERAs/EOBs.
- Research open accounts receivables, resolves claims errors and reprocesses claims for successful payment.
- Maintains integrity of patient ledgers, following guidelines provided to manage balances.
- Submits claims electronically and by paper as required. This includes sending secondary claims with attached explanation of benefits.
- Answers incoming questions from patients and clinic team members regarding open account balances and billing issues.
- Ensures compliance with all HIPAA/HITECH requirements as legally required and all applicable federal, state and local regulations.
- Acts as a liaison and provides excellent customer support to teammates in our optometry practices.
- Minimal travel to field practices may be required to meet with peers, develop strong rapport, and understand our business.
- All other duties as assigned.
OTHER SKILLS:
- Has excellent customer service skills.
- Presents professionally and communicates clearly.
- Embraces and aims for a paperless work environment.
- Demonstrates ability to solve problems and work as a positive member of a team.
- Is technology savvy and appreciates finding new ways to make processes easier.
- Can stay focused on projects and can multi-task when needed.
- Brings his/her best self to work every day and can contribute positively to a team environment.
- Desires a long-term growth opportunity.
Additional Desired Experience (not a requirement):
- Healthcare payment posting
- Healthcare insurance and patient collections
- Acuity Logic, Compulink, Eyefinity PM and/or Officemate experience a plusOptical billing, Vision Therapy billing, Medicare & Medi-Cal billing experience a plus
PHYSICAL REQUIREMENTS:
- Hearing. Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.
- Hand dexterity and eye and hand coordination is critical.
- Lifting. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Use of one or both arms and wrists in lifting files, documents, etc. on a frequent basis.
- Sitting. Must be able to sit for long periods of time.
- Standing. Particularly for sustained periods of time.
- Talking. Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately or quickly.
- Travel as needed between practices.
- Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned or to make general observations of structures. Must be able to read a computer screen for long periods of time.
- Walking. Moving about on foot to accomplish tasks, particularly for long distances or moving from one workstation to another.