Billing Specialist

Total Vision; Mission Viejo (CA); On-site; USD 48,000 - 62,000; Full time

Job summary

Total Vision in Mission Viejo, California, is seeking a detail-oriented Billing Specialist to review patient statements, process refunds, and manage AR across multiple optometry locations. The role requires interpreting EOP/EOBs and ensuring timely, accurate postings in our billing system.

Candidates should excel in customer service, maintain professional communication, and embrace a paperless workflow while collaborating with clinic teams to resolve billing issues and improve processes.

Qualifications

• Customer service skills and professional communication required.
• Desire for a paperless work environment and process improvement.
• Ability to solve problems and work well in a team.
• Technically proficient and able to learn new billing tools.

Responsibilities

• Review and process patient statements for multiple locations.
• Process refund requests and post refunds accurately.
• Read and interpret EOP/EOBs and resolve issues.
• Post payments, chargebacks, adjustments, and remark codes.
• Research open AR and reprocess claims to secure payment.
• Maintain patient ledgers and manage balances.
• Submit claims electronically and on paper as required.
• Respond to patient and clinic questions about balances and billing.

Skills

Customer service

Professional communication

Paperless workflow

Problem solving

Tech savviness

Multi-tasking

Team player

Growth mindset

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 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 plus

Requirements

• 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.