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Description The Medical Biller will be responsible for managing the billing process for our ophthalmology services, ensuring accurate coding, submitting claims, and following up on payments. You will collaborate with both patients and insurance providers to ensure the timely processing and payment of claims. This position requires strong knowledge of medical billing procedures, ophthalmology-specific coding, and excellent attention to detail.

Key Responsibilities:

Insurance Verification: Verify patient insurance coverage and eligibility prior to appointments to ensure accurate billing.

Medical Coding: Utilize ICD-10, CPT, and HCPCS codes specific to ophthalmology services for accurate charge entry and claims submission.

Claim Submission: Submit electronic and paper claims to insurance companies in a timely and accurate manner.

Claims Follow-Up: Monitor and follow up on unpaid or denied claims, resolving issues promptly with insurance companies and patients.

Payment Posting: Post payments from insurance companies and patients to patient accounts, ensuring accuracy and completeness.

Patient Billing: Generate and send patient statements, answer billing inquiries, and assist with payment plans as needed.

Insurance Reconciliation: Reconcile and review insurance payments to ensure they match the amounts billed and resolve discrepancies.

Compliance: Ensure all billing practices are compliant with federal, state, and insurance regulations, including HIPAA requirements.

Record Maintenance: Maintain accurate and organized patient billing records, ensuring confidentiality and proper documentation.

Collaboration: Work closely with the ophthalmologists, office staff, and insurance representatives to resolve billing issues and improve billing processes.

Qualifications:

Education: High school diploma or equivalent required; Associate's degree in Health Information Technology, Medical Billing, or a related field is preferred.

Experience: Minimum of 2 years of experience in medical billing, with a preference for experience in ophthalmology or a similar healthcare specialty.

Knowledge: Strong understanding of ICD-10, CPT, and HCPCS codes, particularly for ophthalmology services.

Skills:

Proficient with electronic medical records (EMR) and billing software (experience with [insert specific software, e.g., TrakCare, AdvancedMD, Kareo, etc.])

Excellent communication skills, both verbal and written

Detail-oriented with strong organizational skills

Ability to work independently and as part of a team

Familiarity with insurance company guidelines and payer policies Requirements Medical Billing, Medical Collections, Medical Denials, Medical Appeals, Hospital Billing

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