Medical Billing Specialist

Associated Retina Consultants; Peoria (AZ); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Holidays

Vacation and Sick Time

Job summary

Associated Retina Consultants seeks a detail-oriented Medical Billing Specialist to handle posting insurance payments, entering charges, and assisting patients with their accounts. The role emphasizes accuracy in CPT/ICD-10 coding and referrals, with HIPAA compliance throughout.

Experience with insurance guidelines (HMO/PPO, Medicare, Medicaid) and EMR systems is essential. The position requires teamwork, strong communication, and the ability to manage multiple tasks efficiently in a clinic

Qualifications

• High school diploma or equivalent required.
• 2+ years medical billing experience preferred.
• Knowledge of HMO/PPO, Medicare, Medicaid payer requirements.

Responsibilities

• Post insurance payments and enter charges accurately.
• Assist patients with account questions and referrals.
• Verify accuracy of claims before submission to maximize reimbursement.
• Review claims and denials to reduce errors and denials.
• Utilize aging reports to follow up on unpaid claims over 30 days.
• Respond to inquiries from insurance companies, patients, and providers.

Skills

Attention to detail

Planning and organizing

Problem-solving

Teamwork

Multitasking

Customer service

Electronic Medical Records (EMR)

Communication skills

Education

High School Diploma or Equivalent

Tools

Microsoft Word

Microsoft Outlook

Excel

10-key calculator

Job description

About UsSince 1974, Associated Retina Consultants has an experienced team of Arizona eye specialists to diagnose and treat your vision problem. Our focus is on the retina, macula, and the vitreous humor in the eye. We work hard every day to protect and save our patients vision, helping them lead better quality lives.Position Summary:We are looking for an organized, efficient Medical Billing Specialist with an eye for detail and high level of accuracy. The Billing Specialist is responsible for posting insurance payments, entering charges, and assisting patients with their accounts. Position requires accuracy, thoroughness, and a good understanding of insurance procedures for referrals, co-pays, deductibles, allowable, CPT codes and Dx codes.Responsibilities:Work with personal information and maintain patient confidentialityWeekly and monthly reporting to executive director and billing supervisor.Verify the accuracy of all claims before submission and ensure all claims are submitted with a goal of zero errors and review claims and claims denials to ensure maximum reimbursement for services provided.Utilize monthly aging accounts receivable reports for follow-up on unpaid claims aged over 30 days.Review referrals and authorizationsRespond to questions and complaints from patients or insurance companiesResearch and appeal denied claims.Read and interpret insurance explanation of benefits and respond to inquiries from insurance companies, patients, and providers.Other responsibilities as judgment or necessity dictate.Meet defined department goals and activity metrics.Initiate late payment notices to relevant partiesIdentify and bill secondary and/or third-party insurances.Follow set billing processes and procedures and follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO.Ensure patient information is accurate and complete and request any missing patient information.Create both paper and electronic copies of documentationCollect delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur.Education and Experience:High School Diploma or Equivalent required.2+ years medical billing experience preferred.Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.Proficient in Microsoft Word, Outlook, Excel, and 10 key calculators.Basic knowledge of medical terminology, including CPT/ICD-10 coding.Effective communication abilities for phone contacts with insurance payers to resolve issues.Knowledge of medical terminology likely to be encountered in medical claimsMaintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).Skills:Planning and organizingAttention to detail, accuracy, and efficiencyProblem-solvingTeamworkMultitaskingCustomer serviceElectronic Medical Records (EMR)Communication skills - verbal and writtenIntegrityBenefits: Medical, Dental, Vision, Life Insurance, Disability Insurance, Paid Holidays, Vacation and Sick Time and much more.Physical Requirements:Prolonged periods sitting at a desk and working on a computer.Must be able to lift up to 15 pounds at times.In office environment with controlled atmosphere. Possible exposure to staff or patients with communicable diseases and blood borne pathogens.The Company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employees ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the Company reserves the right to change this job description and/or assign tasks for the employee to perform, as the Company may deem appropriate.Associated Retina Consultants is an Equal Opportunity Employer.