Insurance & Billing Specialist

Whitewater Eye Centers LLC; Chicago (IL); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player seeks a detail-oriented Insurance & Billing Specialist to enhance financial health and manage billing cycles effectively. This role involves working closely with insurance payers to address account receivables, resolve denials, and ensure accurate billing practices. The ideal candidate will possess strong organizational skills, a solid understanding of medical billing and coding, and the ability to communicate effectively with both management and patients. Join a dynamic team where your contributions will directly impact the financial success of the organization while upholding the highest standards of patient care and confidentiality.

Qualifications

• 3+ years of medical billing experience with focus on insurance denials.
• Knowledge of CPT and ICD-10 coding is essential.

Responsibilities

• Prioritize and resolve denied insurance claims efficiently.
• Maintain patient confidentiality and comply with HIPAA regulations.

Skills

Organizational Skills

Computer Literacy

Bookkeeping Skills

Knowledge of Insurance Rules

Knowledge of CPT and ICD-10 Coding

Teamwork

Project Management

Patient Interaction

Education

Three years of medical billing & coding experience

Experience in EHR billing system

Additional certifications related to medical billing

Tools

NexTech EHR

Medical Billing Software

Job description

Position: Insurance & Billing Specialist

Location: Richmond, IN

Remote Status: On-Site

Job Id: 163

# of Openings: 2

About the Position: The Billing Specialist will report to the I & B Manager and will focus on promoting Whitewater Eye Centers financial health and following the billing cycle for all locations to maximize cash flow. The Billing Specialist will work closely with insurance payers to go over account receivables, work denials, billing, payment posting, understand policy and guideline changes, recoupment payments, correspondence letters, and going over patient balances.

*This position will primarily focus on insurance denials*

Required Education and Experience:

1. Three years of medical billing & coding experience; at least two years processing medical denials.
2. Experience in EHR billing system; NexTech preferred
3. Additional certifications related to medical billing and coding preferred.

Essential Skills and Abilities:

1. Strong organizational skills and attention to detail.
2. Computer literacy, including knowledge of software programs utilized in the practice.
3. Bookkeeping skills with a working knowledge of medical billing software.
4. Knowledge of insurance rules and regulations, including Medicare/Medicaid
5. Knowledge of CPT and ICD-10 coding.
6. Ability to work as a team member.
7. Management of multiple projects simultaneously.
8. Respectful treatment of patients and co-workers.

Key Responsibilities:

1. Prioritize and review denied insurance claims and resolve billing specified to unpaid claims.
2. Communicate with management to resolve billing disputes and escalations.
3. Review code change requests to determine accurate coding and/or advise coding or billing changes to ensure appropriate reimbursement.
4. Contact carriers and patients to maximize reimbursement on accounts to be worked.
5. Serve as a point of contact for billing problem solving.
6. Respond to correspondence inquiries by phone, mail for resolution.
7. Respond to inquiries from staff members regarding patient charges, coding and eligibility.
8. Maintain high level of patient confidentiality to ensure compliance with HIPAA regulations.
9. Responsible for managing daily billing functions for assigned insurance payer.
10. Responsible for submitting accurate coding and billing procedures to obtain appropriate reimbursement for commercial, government, third party payers, and other network entities.
11. Post payments and balance unapplied payments from carrier remits, self-pay.

Physical Activity of Position:

1. Talking: This position requires expressing or exchanging ideas through the spoken word. This position must participate in activities to convey detailed or essential verbal instructions to physicians, staff, and patients accurately and succinctly.
2. Hearing: This position requires the ability to perceive sounds at normal speaking levels with or without correction, including the ability to receive detailed information through oral communication and discriminate between sounds.
3. Repetitive motion: This position requires substantial movements (motions) of the wrists, hands, and fingers while working on reports or on the computer.
4. Sedentary work: This position may need to occasionally exert up to 10 pounds of force to lift, carry, push, pull, or otherwise move objects. The job consists primarily of sedentary work and mainly involves sitting. Walking and standing are required only occasionally.
5. Visual Requirements: This position requires close visual acuity (with or without correction) to prepare and analyze data and figures, transcribe, view a computer terminal, and read extensively.
6. Environmental Conditions: This position is not substantially exposed to adverse environmental conditions (such as typical office work).

Equal Opportunity Employer:

Whitewater Eye Centers is an equal employment opportunity employer and complies with all applicable laws relating to discrimination against qualified applicants or employees in hiring or in any decision affecting job status, pay, or any other terms and conditions of employment based on race, color, creed, religion, national origin, sex, marital status, familial status, disability, genetic information, sexual orientation, age, or other applicable protected classes.