Medical Insurance/Billing Specialist

The Retina Center is a patient focused practice that treats the retina and other ocular diseases with uncompromising care. If you like fast-paced work, have an upbeat persona, are willing to learn and to be challenged, then come be a member of our team.

Our medical practice currently has a Medical Insurance/Billing Specialist position available which encompasses accounts receivables, insurance eligibility and benefits, coding and billing,and medical records.

Responsibilities:

• Obtaining insurance eligibility and benefits verification
• Calculating patient estimated costs
• Becoming familiar with ophthalmic coding
• Obtaining referrals and authorizations
• Fielding phone calls
• Analyze records to assign appropriate diagnostic (ICD-10) and procedural (CPT) codes
• Identify clinical documentation deficiencies and query providers as appropriate for clarity and completeness.
• Ensure codes are accurate, up-to-date, and sequenced correctly in accordance with government and insurance regulations
• Audit clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes
• Manage rejections, denials, and outstanding claims to determine appropriate remediation action to resolve root causes and reduce/eliminate bill holds resulting from coding gaps
• Stay up to date with the constant changing environment pertaining to medical billing and coding

An ideal candidate will be a mature professional, possess critical thinking with strong attention to detail, while still being able to multi-task while working as a team.

Special consideration will be given to coding certified applicants, college graduates and motivated individuals who have shown commitment, loyalty and a drive for success throughout their work history. However, prior experience in this position is not mandatory, as on site training will be provided.