Patient Accounting Specialist

Does your job have meaning? Sight . . . is a precious gift!

Eye Associates of New Mexico is the largest Ophthalmology and Optometry practice in the Southwest. We have been serving the state of New Mexico since 1976 with compassionate, state-of-the-art, value-based care. Our team approach aims to deliver the highest quality eye care to all while striving to support our employees’ professional development. Perhaps these are some of the reasons why our employees have voted us TOP WORK PLACES locally and nationally since 2022! Come be a part of our team!

We are currently looking for a Full-time Patient Accounting Specialist to work at our Administrative office. This position will work remotely and in the office.

Starting pay $17.00 per hour ,depending on skills/experience

Essential Functions/Responsibilities:

Customer Service

• Answer incoming patient and clinic calls in a timely manner.
• Resolve patient billing issues and follow up with patient if needed
• Manage small balance patient adjustments
• Audit, adjust and/or refund small credits in an appropriate and timely manner
• Responds to patient billing/insurance inquiries via portal or by mail

• Accounts Receivable and Collections

  • Responsible for the management of assigned accounts receivable. To include account adjustments, balance control, refunds and payment allocation from insurance and patients.
  • Calls insurance carriers to check on the status of claims not yet received or on payment discrepancies
  • Audits insurance payments to assure maximum reimbursement to practices; initiates reconsiderations as warranted
  • Audits and challenges denials to ensure maximum payment for services rendered and initiates reconsiderations as warranted.
  • Processes all patient account adjustments including but not limited to corrections, posting errors, contractual arrangements, write offs, and physician approved write offs
  • Notes each encounter/account/task of any correspondence, conversation or steps taken to resolve the balance.
  • Starts and continues to follow up on work log tasks in a timely manner.
  • Keeps work log current and organized
  • Serves as a liaison with payer sites relative to billing (i.e., Medicare, managed care, Medicaid, etc.)
  • Keeps current with regulations and changes in procedures relative to billing and reimbursement in the applicable insurance specialty
  • Ensures the accuracy of reporting CPT codes, modifiers, referring physicians, diagnoses, referrals, etc. to each insurance company compliant with their specific regulations and our compliance program
  • Reports issues in billing that appear at variance with our compliance plan
  • Available for overflow Patient Accounting calls and serves as a patient advocate when patients call. Insures inquiry reaches resolution
  • Performs account audits as requested by patients or needed to insure appropriate insurance payments
  • Collects patients portion and verifies demographics with each incoming patient call
  • Reviews and submits patient responsibility credits for reimbursement in a timely manner.
  • Reviews and insurance responsibility credits and initiates recoupment or refund for reimbursement in a timely manner.
  • Performs daily balancing-out function on a rotating basis
  • Serves on corporate committees as assigned
  • Assists in the resolution of duplicate encounters to ensure that the charges are billed appropriately.
  • Maintain insurance designations in NextGen for employees and their families
  • The annual completion of assigned Learning Management System (LMS) courses is mandatory. Any individual who has not completed their assigned training prior to November 30th of each year may be subject to disciplinary action, up to and including termination of employment.
  • Other duties as assigned.

• Contact Lens

  • Receives orders for contact lenses from EANM providers and staff via email, phone and fax
  • Answers phone and takes contact lens orders from established patients via email and phone
  • Requests charts for replacement contact lens orders
  • Verifies current contact lens prescription using computer database or contacting the clinic where patient was last seen
  • Determines appropriate charges and generates an encounter form
  • Obtains prior authorization from patient’s vision plan, or as necessary, notifies the clinic to obtain this information
  • Places orders with appropriate contact lens vendors within one work day of receipt of order
  • Audits contact lens shipments for completeness
  • Verifies on a routine, monthly basis, all contact lens vendor statements with orders received and submits approved statements to Accounts Payable for processing
  • Maintains perpetual manual and/or computer log of all contact lens transactions with daily entries reflecting lenses ordered, received, entered into inventory, dispensed, billed and collected for. The information will allow for ongoing inventory control and management.
  • Prints, completes and balances encounter forms daily.
  • Enters billing information for contact lenses into the computer

Skills/ Requirements:

• Requires knowledge of CPT and ICD9 codes
• Three years of medical billing experience

Generous Benefits:

• Career Path
• Paid time off (PTO)
• Eight (8) company paid holidays (including the day after Thanksgiving and Christmas Eve!)
• Medical and Dental
• Free Calm app
• Generous Vision benefits for you and your dependents
• Education Assistance Program
• 401(k) and Roth Program
• Flexible Spending Account (FSA)
• Company paid Basic Life and AD&D Insurance, Short Term and Long Term Disability Insurance
• Voluntary Supplemental Life and AD&D
• Financial Wellness Program
• Identity Theft Protection Plan
• Employee Assistance Program
• and more!

Please visit us at www.eyenm.com for more information.

AA/EOE/Disability. Eye Associates of New Mexico is a drug and tobacco-free employer.

Req 2547