Demo

Billing Operations Manager

Surf Search Inc
Orchard, NY Full Time
POSTED ON 4/21/2025
AVAILABLE BEFORE 5/14/2025

Client is a highly successful Ophthalmology Group with 4 locations located in the Buffalo, NY, area. Responsibilities :

  • The timely preparation and filing of insurance claims (paper and electronic claims transmission), insurance aging reports, and prior approvals.
  • The timely review and follow up on all claims and collection of insurance claims and patient accounts.
  • Play an active role in the coding process for medical claims and provider credentialing.

Essential Skills and Abilities : Billing Operations :

  • Strong knowledge of CPT and Diagnosis Coding
  • Credentialing Experience
  • Effective Leadership Skills
  • String knowledge of medical insurance, payments and deductibles
  • Computer literate with spreadsheet and MS Office.
  • Strong mathematical and financial management skills.
  • Working knowledge of standard accounting principles..
  • Ability to manage staff
  • Audits – Prepare responses to all insurance company requests and audits, including provider incentive programs. Conducts Periodic internal chart audits.
  • Personnel Management :

  • Perform annual performance evaluations on all departmental staff and meet with the Administrator to discuss employee performance.
  • Hold staff accountable for accuracy and appropriateness.
  • Train new departmental staff members.
  • Credentialing :

  • Oversee all credentialing for new doctors and / or any renewals with regards to both insurance and hospital requirements.
  • Create and update all physicians on Council for Affordable Quality Healthcare (CAQH) and Provider Enrollment Chain & Ownership System (PECOS) website.
  • Payer and Medical Organization Relations :

  • Maintains appropriate relationships with all insurance provider representatives.
  • Maintains communications with all necessary MLMIC representatives and Medical organizations regarding patient care and physician / patient relations.
  • Qualifications :

  • Associates’ Degree or higher desired.
  • High school diploma or equivalent required.
  • At least 5 years of previous medical office billing experience.
  • Medical Coding Experience Desired.
  • Ophthalmology Experience.
  • Certification in Ophthalmology Coding preferred.
  • Nextech EHR Experience.
  • Strong computer background.
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