Medical Biller/Coder

DaMar Staffing; Chula Vista (CA); On-site; USD 60,000 - 80,000; Full time

Job summary

American Eye Associates is seeking a Full Time Biller/Coder to provide billing support at our Chula Vista location. The role supports the corporate office and satellites, focusing on denial resolution and accurate coding in a fast-paced setting.

The ideal candidate has ophthalmology billing experience, knows CPT/ICD-10/HCPCS, and can navigate insurance portals while maintaining HIPAA compliance. On-site work is required with a collaborative team.

Qualifications

• Understanding and proficient use of medical billing guidelines and regulations.
• Knowledge of CPT, ICD-10, and HCPCS codes, as well as modifier usage.
• Experience with healthcare receivables, insurance claims, denial, and appeal processing.
• Willing to work on-site.
• Familiarity with insurance portals.

Responsibilities

• Process and manage medical claims for ophthalmology patients.
• Submit appeals to insurances and medical groups.
• Review insurance correspondence to ensure accurate reimbursement.
• Use Allscripts work queues to track claims touched and outstanding.
• Escalate unresolved issues through defined channels.
• Maintain PHI confidentiality and HIPAA compliance.

Skills

Medical billing & coding

Claims denial resolution

Regulatory knowledge (CMS/OIG)

HIPAA compliance

PHI confidentiality

Allscripts experience

Insurance claims processing

Tools

Allscripts

Job description

Full Time Biller/ Coder

Our growing Ophthalmology practice has a vacancy for a Full Time Biller/ Coder role. This role will work on-site in our Chula Vista location and provide billing support to the corporate office as well as other satellite clinics. The ideal candidate has experience working in a collections role for an ophthalmology practice. This person will thrive in a busy, fast-paced environment and can multi-task while keeping a superb professional demeanor.

The role will report to the Billing Manager.

We are seeking a talented and proficient Claims Denial Resolution Specialist/ Coder to join our growing team. At American Eye Associates we provide our Specialists the opportunity to learn, be challenged, and grow your career within the Revenue Cycle industry. Ideal candidates will possess claims processing experience and a competitive desire to maximize returns.

• Understanding and proficient use of medical billing guidelines and regulations. Knowledge of regulations as set forth by CMS, OIG, commercial insurances and other regulatory agencies.
• Knowledge of CPT, ICD-10, and HCPCS codes, as well as appropriate modifier usage for Coding and billing
• Experience with healthcare receivables, insurance claims, denial, and appeal processing
• Uses Allscripts work queues to track # claims touched and outstanding claims to process
• Recognizes when additional assistance is needed to resolve claims and escalates appropriately and timely through defined communication and escalation channels.
• Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures.
• Maintains strict confidentiality regarding Patient Health Information (PHI) as well as follows HIPAA regulations.
• Submit appeal to insurances and medical groups
• Answer and review pertinent insurance correspondence to insure complete and accurate reimbursement on claims
• Knowledge and skill navigating insurance portals
• Willing to work on-site

Our organization offers excellent benefits to include 100% paid employee health insurance premiums, low cost dental and vision options, life insurance, disability, 401k, paid holidays, paid vacation and sick time accruals, fun holiday events and gatherings and more!