Billing Specialist

Total-Vision-5; Mission Viejo (CA); On-site; USD 42,000 - 64,000; Full time

Job summary

Total-Vision-5 in Mission Viejo, CA is seeking a patient billing specialist to review and process statements for multiple locations, post payments, refunds, and adjustments, and interpret EOBs with minimal supervision.

The role supports optometry teams, handles inquiries about balances, and complies with HIPAA/HITECH. Some travel to field practices may be required; experience with Acuity Logic, Compulink, Eyefinity PM or Officemate is a plus.

Qualifications

• Has excellent customer service skills.
• Presents professionally and communicates clearly.
• Embraces and aims for a paperless work environment.
• Demonstrates ability to solve problems and work as a positive member of a team.
• Is technology savvy and appreciates finding new ways to make processes easier.

Responsibilities

• Reviews and processes patient statements for multiple locations.
• Process refund requests and post refunds into the system.
• Reads and interprets EOPs/EOBs and resolves issues.
• Posts payments, charge backs, adjustments and remark codes.
• Researches difficult ERAs/EOBs and open accounts receivable to resolve claims.
• Submits claims electronically and on paper as required.
• Answers questions from patients and clinic staff about balances and billing.
• Ensures HIPAA/HITECH compliance and all regulations.
• Acts as a liaison to support optometry practices and teams.
• May travel to field practices to meet peers and build rapport.

Skills

Customer service

Professional communication

Problem solving

Team player

Tech-savvy

Tools

Acuity Logic

Compulink

Eyefinity PM

Officemate

Job description

Duties/Responsibilities• Reviews and processes patient statements for multiple locations.• Process refund requests and post refunds into the system.• Reads and interprets insurance Explanations of Payments (EOP) or Explanations of Benefits (EOB) with understanding and can independently take appropriate next steps to resolve issues.• Posts payments, charge backs, adjustments and remark codes in a timely and accurate manner.• Research difficult ERAs/EOBs.• Research open accounts receivables, resolves claims errors and reprocesses claims for successful payment.• Maintains integrity of patient ledgers, following guidelines provided to manage balances.• Submits claims electronically and by paper as required. This includes sending secondary claims with attached explanation of benefits.• Answers incoming questions from patients and clinic team members regarding open account balances and billing issues.• Ensures compliance with all HIPAA/HITECH requirements as legally required and all applicable federal, state and local regulations.• Acts as a liaison and provides excellent customer support to teammates in our optometry practices.• Minimal travel to field practices may be required to meet with peers, develop strong rapport, and understand our business.• All other duties as assigned.Required Skills/Abilities• Has excellent customer service skills.• Presents professionally and communicates clearly.• Embraces and aims for a paperless work environment.• Demonstrates ability to solve problems and work as a positive member of a team.• Is technology savvy and appreciates finding new ways to make processes easier.• Can stay focused on projects and can multi-task when needed.• Brings his/her best self to work every day and can contribute positively to a team environment.• Desires a long-term growth opportunity.Additional Desired Experience• Healthcare payment posting • Healthcare insurance and patient collections• Acuity Logic, Compulink, Eyefinity PM and/or Officemate experience a plus• Optical billing, Vision Therapy billing, Medicare & Medi-Cal billing experience a plusRequirements• Hearing. Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.• Hand dexterity and eye and hand coordination is critical.• Lifting. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Use of one or both arms and wrists in lifting files, documents, etc. on a frequent basis.• Sitting. Must be able to sit for long periods of time.• Standing. Particularly for sustained periods of time.• Talking. Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately or quickly.• Travel as needed between practices.• Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned or to make general observations of structures. Must be able to read a computer screen for long periods of time.• Walking. Moving about on foot to accomplish tasks, particularly for long distances or moving from one workstation to another.