Medical Billing Specialist from Collabera

The billing process involves applying information from the patient’s eyeglasses prescription and determining the correct codes and charges for each item and service provided as well payment reconciliation resulting in efficient accounts receivable management.

Review charges in the patient’s account and correctly enter claims into the insurance carrier’s billing system

Post payments received by insurance carrier at the line-item level.

Review payments for collection accuracy and re-bill as needed.

Differentiate between a refractive and a medical diagnosis and apply the diagnosis to the service rendered

Multiple software programs and reference sheets are utilized and the Billing Specialist should be confident in navigating between these programs and tools to effectively process claims for eyeglasses, contact lenses, and routine vision services

Complete tasks as assigned and will be provided with a production goal in terms of number of claims to be correctly processed in a specified time

Maintain a list of claims that are unable to be filed

Recognize different insurance plans and follow coding directives

Read optical prescriptions and assign appropriate codes (with training/guides)

Recognize demographic errors in patient’s chart and correcting (e.g., misspelled name)

Refer to plan pages from insurance to apply appropriate modifiers to codes

High School Diploma

1 year of office experience

Some previous medical experience and billing experience preferred

Familiarity with CPT, HCPC, and ICD9

Willing to learn coding for optical products

Efficient and accurate entry of claims into specified insurance portals

Working knowledge of Excel, PDF, and other common desktop programs

Ability to navigate multiple internet portals simultaneously on different screens

Problem-solving and ability to work independently

Medical office background, specifically billing, coding experience preferred.

Ability to review and process information and apply correct coding and charges to outgoing claims.

Familiarity with EOP's (Explanation of Payments / Benefits) preferred.

Internet savvy and ability to gather data from multiple sources as needed to complete claims or verify eligibility of benefits.

Strong attention to detail, communication skills and accuracy are a must.