Job Summary

The Ophthalmology Billing Specialist processes and ensures accuracy and compliance of all claims. They maintain practice management records to provide up to date information regarding demographics, insurance information, payments and communications.

The Specialist fosters close working relationships with all parties to ensure coding that complies with and is up to date with regulatory rules. The Specialist must always maintain complete confidentiality as required by law. The Specialist has an excellent understanding of CPT, ICD-10, HCPCs and HIPAA as well as any state specific requirements.

The Billing Specialist must be self-directed and able to multitask in a high-paced environment with minimal direction. A thorough knowledge of the workings of medical practices is a requirement. 

Essential Duties and Responsibilities include the following (other duties may be assigned) :

• Process submitted claims
• Process received payments
• Work claim rejections and denials
• Process Payment Reminders and Statements
• Work A/R
• Eligibility and Benefit Inquiries
• Customer Service Inquiries
• Authorizations
• Collection processes
• Prepare monthly reports for management
• Train new staff
• Special projects as needed

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and Experience:

• GED or High School Diploma
• Medical billing experience in Ophthalmology is a must.
• CPT, ICD-10, HCPCs, NCCI, Fee Schedules and HIPAA knowledge required.
• Prior experience with billing in Modernizing Medicine is a plus.

Computer Skills:

Microsoft Windows, Microsoft Office Suite, Email, Calendar and Scheduling Software, Medical Software, Internet, Data Entry

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually low to moderate. The work environment is indoors and environmentally controlled. Work environment is structured. May have exposure to disease or infections.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands and arms to handle, grasp, position, move and control objects and tools; reach with hands and arms; and talk and hear. Specific vision abilities required by this job include near vision, distance vision, depth perception and ability to adjust focus.

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

SharpeVision, PLLC is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

 Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible schedule
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Paid training
• Retirement plan