Medical Billing Specialist - Denials & Reimbursement

Claris-Vision-LLC; Dartmouth (MA); On-site; USD 26,000 - 30,000; Full time

Job summary

Claris Vision in Dartmouth, MA is seeking a Billing Specialist to handle paper and electronic claims for primary and secondary payers. You will monitor aging, respond to billing inquiries, and prepare daily activity and balancing reports to maximize reimbursement.

Ideal candidates hold an Associate degree, 2–5 years in medical billing or related fields, and CPC/HIT certification. Ophthalmology experience and denial-management skills are highly valued for this role.

Qualifications

• Associates degree plus 2–5 years experience in medical billing, medical office collections, or insurance verification.
• CPC/HIT certification required. COPC certification or willingness to obtain COPC within 3 months of hire.

Responsibilities

• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers, Medicare, and Medicaid.
• Receive payment denials, investigate, and rectify the situation with payer or patient; includes claim reconsiderations and appeals.
• Review assigned aging reports and follow up on outstanding claims.
• Coordinate with office leads to obtain referrals, pre-authorizations, and verification for denied claims.
• Initiate private pay collections after insurance cancellation or denials.
• Assist patients with self-pay arrangements and CareCredit applications.
• Post insurance and patient payments to open invoices promptly and reconcile accounts.

Skills

Denial management

Insurance rules

Coding guidelines

HIPAA compliance

Customer service

Telephone etiquette

Detail oriented

Ophthalmology experience

Education

Associates degree

CPC/HIT certification

Tools

EMR software

Scheduling software

Job description

Claris Vision in Dartmouth, MA is seeking a Billing Specialist to handle paper and electronic claims for primary and secondary payers. You will monitor aging, respond to billing inquiries, and prepare daily activity and balancing reports to maximize reimbursement.

Ideal candidates hold an Associate degree, 2–5 years in medical billing or related fields, and CPC/HIT certification. Ophthalmology experience and denial-management skills are highly valued for this role.