Medical Billing/Authorization Specialist

Medical Billing/Authorization Specialist

Vitreo-Retinal Consultants, an ophthalmology practice specializing in the treatment of retinal diseases, is looking for a detail-oriented, professional and reliable person to join their team in the Canton location. The Medical Billing/Authorization Specialist must possess thorough working knowledge with the skills to independently and appropriately work accounts receivable and obtain authorizations. This includes the ability to answer billing inquiries from patients and office staff, possess a working knowledge of both the practice management and electronic medical records, have the ability and knowledge to electronically submit claims, post electronic payments and work denied claims appropriately. Our goal is to ensure that all physicians services are billed in a timely and accurate manner to allow for the highest reimbursement.

Responsibilities Include:

• Read and understand explanation of benefits.
• Knowledge of CPT codes, Modifiers, and ICD-10 codes.
• High level understanding of common denials (LCD, NDC, CLIA, bundling, etc.).
• Assure all charges are entered correctly and balance multiple office charges and payments.
• Make necessary changes to patient accounts (address, name, telephone number, and insurance changes, etc.).
• Insurance verification.
• Knowledge of prior authorization process.
• Assure that all electronic and paper claims are sent out timely.
• Review and work claim edits and rejections daily.
• Assist in posting all patient and insurance payments.
• Prepare and send appeals.
• Identify payor related issues and report them to the billing manager
• Answer telephone calls regarding billing inquiries.
• Submit copies of overpaid accounts to billing manager for review.
• Send accounts to collections based on practice policy.
• Assist with setting up patient payment plans.
• Assist in training new employees.
• Maintain strictest confidentiality of patient private health information (PHI) by disclosing only the information requested.
• Perform additional duties as assigned by management.

Qualifications and Skills Required:

· Minimum of 3 years of experience in medical billing and authorization experience

· NextGen experience is a plus.

This is a Monday through Friday daytime position.

Vitreo-Retinal Consultants offers a very competitive compensation package, including excellent insurance benefits and retirement plan.

If this describes your interest and experience, we would welcome a conversation with you.

KEY WORDS: biller, prior authorization, CPT codes, Insurance verification.

Job Type: Full-time

Pay: $17.00 - $22.00 per hour

Expected hours: 35 – 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work setting:

• Private practice

People with a criminal record are encouraged to apply

Ability to Commute:

• Canton, OH 44718 (Required)

Work Location: In person