Eyeglasses Program Billing Specialist

JOB SUMMARY

This position will monitor the Cherokee Nation Eyeglasses Program billing and payments by checking each incoming CNEP order to ensure the proper amounts of money have been billed for each order. Ensure the request to Cherokee Nation Purchased and Referred Care (CNPRC) for each order has been entered into the CN Center software system consistent with Cherokee Nation protocols and print the list of orders with requests for more information entered by CNPRC by clinic and provide this to the appropriate administrative Deans and Cherokee Nation Clinic Managers to ensure each is aware of the number of outstanding orders being denied or held for more information prior to being authorized for payment along with removing the patients with paid CNEP orders from the Cherokee Nation Cemer software system as payments are posted to the NSU Revolution Software system.

MAJOR DUTIES

Daily verify each CNEP order has been entered correctly into the NSUOCO Revolution EHR software by comparing the total invoice amount to the CNEP to the sum of the individual item amounts from the current NSU Cherokee Nation price list.
Place the order on hold if a significant discrepancy exists (>$10 difference) and notify the appropriate clinic to correct the order accordingly.
Remove the order from hold when a corrected order is received
Reminder to the appropriate clinic Office Manager if a corrected order is not received within one week.
Mark orders in the CNPRC Cemer software as paid once payment has been posted to the NSUOCO Revolution software patient account and the eyeglasses have been marked as dispensed in the CNPRC Cemer software.
Montly print CNEP orders marked as denied and on-hold for more information in the CNPRC Cemer software by clinic and distribute to the appropriate administrative Dean and Cherokee Nation Clinic Office Manager through Revolution Messaging System.
Maintain confidentiality of patient information protected by Federal HIPAA privacy rules and regulators.

Other duties as time permits and assigned.
Must be able to maintain regular attendance.

KNOWLEDGE REQUIRED BY THE POSITION

Knowledge of keyboarding, computer software skills, spreadsheets.

Knowledge of NSUOCO Revolution EHR software, Cherokee Nation Cemer software system, VSP Evefinity software system.

Understanding of billable items of an eyeglasses order, the NSUOCO Eyeglasses price list, vision care insurance and billable amounts for eyeglasses for Vision Service Plan (VSP), Vision Care Direct (VCD) federal Medicare program (MC) and Oklahoma SoonerCare programs (SC).

Knowledge of Health Insurance Portability and Accountability Act requirements.

Knowledge of patient confidentiality guidelines.

Skill in the operation of computers and job related software programs.

Skill in decision making and problem solving.

Skill in interpersonal relations and in dealing with the public.

Skill in oral and written communication.

SUPERVISORY CONTROLS

The Clinical Management Coordinator assigns work in terms of general instructions. The supervisor spot-checks completed work for compliance with procedures, accuracy, and the nature and propriety of the final results.

GUIDELINES

Guidelines include generally accepted accounting principles and university, insurance company policies, and college policies and procedures. These guidelines are generally clear and specific, but may require some interpretation in application.

COMPLEXITY/SCOPE OF WORK

The work consists of related specialized duties. Strict regulations and the need for accuracy contribute to the complexity of the position.

The purpose of this position is to provide specialized support for clinic billing operations. Success in this position contributes to the efficiency and effectiveness of those operations.

CONTACTS

Contacts are typically with co-workers, Cherokee Nation optical staff and Cherokee Nation Clinic Managers, NSUOCO Clinic Billing staff and Spectacle Fabrication staff, officials as requested.

Contacts are typically to give or exchange information, to resolve problems, to provide services, or to justify, defend or settle matters.

PHYSICAL DEMANDS/ WORK ENVIRONMENT

The work is typically performed while sitting at a desk or table or while intermittently sitting, standing, or stooping. The employee occasionally lifts light objects.

The work is typically performed in an office.

SUPERVISORY AND MANAGEMENT RESPONSIBILITY

None.

MINIMUM QUALIFICATIONS

Knowledge and level of competency commonly associated with completion of specialized training in the field of work, in addition to basic skills typically associated with a high school education.

Familiarity with Microsoft software including Word, Excel, Microsoft Windows, copiers and scanners.

PREFERRED QUALIFICATIONS

Annual salary $28,188.00 with excellent benefits, including generous leave time
Anticipated hire date 3/17/2025
Applications will be accepted until 3/1/2025
NOTE: Posting will close to applicants at ll:59 p.m., CST, on the date above. An application cannot be changed after it has been submitted.

To complete the application process, it is critical to create a profile.

Notice to applicants
It is Northeastern State University’s policy that all newly hired employees must provide an original social security card during the hiring process. Failure to provide an original social security card will delay the hiring process and ability to begin employment.