SUMMARY: This position is responsible for preparing and billing patients and insurances, receiving and posting receipts to billing systems, making cash deposits electronically, and reconciling these accounts accurately as well as maximizing payment amount and turn-around time.

DUTIES AND RESPONSIBILITIES:

· Processing medical and/or vision claims generated within the practice management software system daily

· Create claim batches and process all insurance claims daily

· Understanding of claim edits and know the appropriate actions to take to correct the claim prior to submission

· Prepare claim resubmissions, appeals and reviews

· Research correct ICD and CPT codes to get claims paid for any rejections

· Contact patient when necessary to obtain correct information to get the claim paid

· Call insurance company when necessary to find out why claim is rejecting, and follow through by correcting information and resubmitting the claim for payment

· Work with clinics to gather additional information that may be needed to correct a claim for submission to payor

· Meet timely deadlines specified by management when billing charges

· Maintain organized filing system for uploaded batches

· Work well with team members

· Other duties as assigned

· Support and backup other areas of the department as needed

· Answer patient and insurance calls

QUALIFICATIONS:

· Positive, upbeat attitude

· Analytical Problem-Solving Skills

· Strong attention to detail

· Effectively manage multiple priorities

· Proficient computer skills including experience with Microsoft Excel and the internet

· Effective communication with peers, managers, and all individuals affiliated with the company

· Ability to work well in a team environment

· Deadline Driven

· High school diploma or equivalent is required

· Medical collections experience Preferred

· Customer service experience Preferred

· Experience in Ophthalmology, Ambulatory Surgery and NextGen/EMA is preferred