Billing/Invoicing Processor

GENERAL FUNCTION
The Medical Billing/Invoicing Coordinator is responsible for monitoring insurance carrier adjudication of medical claims for one or more doctor practices. Utilize an EHR system and clearing house to review and submit claims to multiple insurance carriers. Review open/unpaid claim balances and take timely action as required.

MAJOR DUTIES & RESPONSIBILITIES

• Review medical claims and transmit to the insurance carrier using the electronic health records (EHR) system and clearing house.
• Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
• Download insurance carrier evidence of benefits (EOBs) to post claim payments and denials in the EHR system.
• Determine if denied claims can be adjusted and re-submitted to the carrier.
• Review aging reports to research open balances and resubmit within insurance carrier filing limits.
• Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
• Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
• Initiate overpayment refunds to patients and repayments to insurance carriers when required.
• Write-off open claim balances in the EHR system.
• Serve as the point of contact for the practice regarding all vision and medical claims.
• Support the corporate manager in maximizing claim collection rate.

BASIC QUALIFICATIONS

• 3 years of related work experience
• Experience with medical vision claims and coding
• Ability to prioritize handling of issues
• Organizational skills and ability to multitask
• Effective communication skills (verbal, written, listening, presentation)
• Proven ability to identify issues and solve problems

PREFERRED QUALIFICATIONS

• Ophthalmology experience working in multiple doctor practices
• Experience working with multiple insurance carriers and an understanding of their claim requirements