Optical Biller

OPTICAL INSURANCE AND BILLING CLERK

JOB DESCRIPTION

POSITION: Optical Insurance and Billing Clerk

DEPARTMENT: Optical

REPORTS TO: Optical Insurance and Billing Manager

JOB SUMMARY: Responsible for daily balancing operations at all Williamson Eye Center Optical locations; processes insurance claims for materials purchased in optical department.

QUALIFICATIONS: High School Diploma or equivalent

ESSENTIAL SKILLS AND ABILITIES:

1. Identifies key issues and takes appropriate action to ensure revenue maximization on individual patient accounts.

2. Perform basic accounting accounting skills as related to patient and vision plan charges.
3. Basic computer skills.

RESPONSIBILITIES: Demonstrate the ability to perform and complete the following skills pertaining to this position.
The skills include, but are not limited to:

1. Mission Statement - At all times, represents the WEC mission by always demonstrating professional and thoughtful behaviors; promoting goodwill, both internally and externally, with unwavering focus on patient care and exceeding patient expectations.

2. Maintains a working knowledge of insurance carriers, payors, and processes utilized within the department.

3. Day and month end closing for multiple optical locations.
4. Processing claims for materials purchased in optical department through various insurance carries.
5. Demonstrates a working knowledge of insurance EOBs and claim denials with the ability to explain coverage details to patients.
6. Send patient orders through the proper channels for fabrication of eyewear in a timely manner.
7. Ensure all patient information is documented, either in writing or in software system, in accordance with office protocol.
8. Reports any claim denial problems to management for review.
9. Notify supervisory staff of patient complaint or problem either communicated by the patient or identified by an employee.
10. Always verifying that your patient name, date of birth, address and phone number are listed and spelled correctly, as they appear on the patient’s insurance card.
11. Request approval form management for any exchanges or refunds requested.
12. Accurately complete all required tracking and production reports as directed by supervisory staff.
13. Attend all required staff meetings and training sessions.
14. Complete all daily accounting duties in accordance with office protocol.
15. Manage personal patient information in a secure and confidential manner ensuring all communication, both verbal and visual, are in compliance with HIPPA regulations.
16. Adhere to and uphold all local, state and federal compliance requirements as they relate to optical operations. Adhere to and uphold compliance of all internal practice policies and procedures as required by
Williamson Eye Center.

ORGANIZATIONAL POLICIES:

1. Personal Appearance - Dresses appropriately for position; keeps self well groomed.

2. Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.

3. Dependability- Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with alternate plan.

4. Safety and Security- Observes safety and security procedures; determines appropriate action beyond guidelines; reports potentially unsafe conditions; uses equipment and materials properly.

5. 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 essential functions.

While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee is frequently required to stand; walk; reach with hands and arms; climb or balance; stoop, kneel, crouch or crawl. The employee is occasionally required to sit. The employee must regularly lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

6. 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.

7. Quality- Demonstrates accuracy and thoroughness; looks for ways to improve and promote quality; applies feedback to improve performance; monitors own work to ensure quality.

8. Quantity- Meets productivity standards; completes work in timely manner; strives to increase productivity.

Job Type: Full-time

Pay: From $17.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to Commute:

• Baton Rouge, LA 70806 (Required)

Work Location: In person

Salary : $17