Job Description
Job Description
Description:
The billing process involves applying information from the patient’s eyeglasses prescription and determining the correct codes and charges for each item and service provided as well payment reconciliation resulting in efficient accounts receivable management.
Essential Functions:
Review charges in the patient’s account and correctly enter claims into the insurance carrier’s billing system
Post payments received by insurance carriers at the line-item level.
Review payments for collection accuracy and re-bill as needed.
Differentiate between a refractive and a medical diagnosis and apply the diagnosis to the service rendered
Multiple software programs and reference sheets are utilized and the Billing Specialist should be confident in navigating between these programs and tools to effectively process claims for eyeglasses, contact lenses, and routine vision services
Complete tasks as assigned and will be provided with a production goal in terms of number of claims to be correctly processed in a specified time
Maintain a list of claims that are unable to be filed
Recognize different insurance plans and follow coding directives
Read optical prescriptions and assign appropriate codes (with training/guides)
Recognize demographic errors in patient’s chart and correcting (e.g., misspelled name)
Refer to plan pages from insurance to apply appropriate modifiers to codes
Requirements
Job Specifications
Typically has the following skills or abilities:
- High School Diploma
- 1 year of office experience
- Some previous medical experience and billing experience preferred
- Familiarity with CPT, HCPC, and ICD9
- Willing to learn coding for optical products
- Efficient and accurate entry of claims into specified insurance portals
- Working knowledge of Excel, PDF, and other common desktop programs
- Ability to navigate multiple internet portals simultaneously on different screens
- Problem-solving and ability to work independently