Ophthalmic Coding Specialist

Retina Consultants of Texas; Houston (TX); On-site; USD 25,000 - 36,000; Full time

Benefits offered by this job

Medical, Dental, Vision benefits

Paid time off & 8 holidays + floating

Job summary

Retina Consultants of Texas seeks an Ophthalmic Coding Specialist to assign ICD-10-CM and CPT/HCPCS codes for diagnoses and procedures, ensuring accurate sequencing per payer rules. You will review medical records, resolve chart issues, and support billing processes in a fast-paced ophthalmology setting.

Two years in a medical office with CPT/ICD-10 coding experience is preferred; ophthalmic coding and scribe certification are a plus. Office location at Spurs Lane, San Antonio.

Qualifications

• Minimum of two years’ experience in a medical office, preferably ophthalmology.
• Experience in medical billing and knowledge of CPT/ICD-10 coding required.
• Scribe certification preferred.
• Ophthalmic coding preferred.

Responsibilities

• Assign codes to diagnoses and procedures, using ICD and CPT codes.
• Ensure codes are accurate and sequenced correctly per requirements.
• Accurately documents chart errors according to practice protocols.
• Code minor and major surgical procedures (intravitreal injections/retina surgeries).
• Assist with initiating billing and re-billing for various procedures using CPT/ICD coding.
• Conduct internal chart audits.
• Collaborate with cross-functional teams to resolve billing inquiries.
• Respond to insurer inquiries in company systems.
• Monitor aging accounts to identify delinquencies.
• Handle business office calls as needed.
• Represent the practice professionally to patients and staff.

Skills

OPH eye terminology

CPT/ICD-10 coding

HIPAA knowledge

NextGen EHR

Nextech

Education

High school diploma or GED

College degree preferred

Tools

NextGen EHR

Nextech

Job description

Overview

Retina Consultants of Texas (RCTX) is seeking an Ophthalmic Coding Specialist to join our innovative team with the mission of Fighting Blindness For The World To See. This position will review medical records and assign accurate diagnosis and procedure codes to the patient's health information record. This responsibility requires appropriate code assignment for physician-documented patient diagnoses, conditions, and procedures utilizing various coding classification schemes, including ICD-10-CM (may include PCS), and HCPCS/CPT. This role will report to our Spurs Lane office in San Antonio.

About RCTX

Retina Consultants of Texas is the largest and most respected retina-only ophthalmology practice in the United States. Our group consists of 26 world-renowned physicians leading the world in retinal care. While serving two major metropolitan markets (and their extensions), our combined culture allows us to best serve our patients, referral sources, and our own team of physicians. RCTX also invests heavily in diagnostic equipment, providing state-of-the-art retina imaging, laser, and diagnostic capabilities to each patient. This, combined with the clinical expertise of our physicians, an outstanding and devoted staff, and 25 convenient locations to serve our patients.

Culture & Values

We worked hard to create our culture as Retina Warriors. We strongly emphasize our core values of Hard Work, Authentic Care and Innovation in everything we do. It is our belief that by investing in our people, our people will be empowered of their own accord to provide the highest quality patient experience.

Benefits

• Employee Paid Benefits such as Medical, Dental, and Vision, short-term disability, voluntary life insurance, accident, critical illness, hospital indemnity, pet insurance, HSA pre-taxed contributions, 401 (k) retirement savings contributions both Roth and Traditional options starting date of hire.
• Employer Paid Benefits such as long-term disability, $25,000 basic life insurance policy, 3% 401(k) safe harbor contribution, HSA employer contributions, annual performance merit increases, certification opportunities, rewards & recognition platform, WellHub Starter Plan Gym Membership, paid time off, and (8) paid holidays + (1) floating holiday annually.

Pay Rate is $22.00+ per hour and is eligible for overtime.

Equal Opportunity

RCTX is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, age, national origin, disability, military service, veteran status, genetic information, or any other protected class under applicable law.

Responsibilities

• Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes.
• Ensure codes are accurate and sequenced correctly in accordance with government and insurance requirements.
• Accurately documents chart errors according to practice protocols.
• Code minor and major surgical procedures (intravitreal injections/retina surgeries)
• Assists with initiating billing and re-billing for various procedures using appropriate CPT/ ICD coding.
• Conduct internal chart audits
• Partner with cross-functional teams to resolve patient billing questions and inquiries
• Respond timely to insurance company inquiries in company systems
• Monitor aging accounts report to identify accounts with delinquent items to action
• Handle business office phone calls as needed
• Represent the practice in a professional manner and treat all patients, both internal and external, in a courteous manner
• Performs other tasks as required.

Skills / Competencies

• Basic understanding of algebraic principles.
• Knowledge of minor and major surgical procedures (intravitreal injections/retina surgeries)
• Understands Medicare and other common insurance requirements for quality reporting in order to help practice comply with payer requirements.
• Knows required components of examination for appropriate coding (ICD-10 selection/CPT coding) to ensure all elements are accurately completed.
• Training and understanding of HIPAA requirements and the importance of maintaining patient confidentiality.
• Ability to learn Nextgen/Nextech quickly and efficiently
• Strong, professional interpersonal skills.
• Understanding of medical terminology and/or ophthalmic terminology
• Maintain calm and positive attitude and maintain a professional demeanor in stressful situations. Have the ability to respond to changing workload and work environment.
• Excellent verbal and written communication.
• Management of multiple projects simultaneously.
• Strong computer skills with a high degree of accuracy on data entry and attention to detail
• Must maintain patient confidentiality in accordance with clinic policy and HIPPA guidelines.

Qualifications

Education Requirements

• High school diploma or GED equivalent
• College degree preferred

Experience Requirements

• Minimum of two years’ experience in a medical office, preferably an ophthalmology office.
• Experience in medical billing and knowledge of CPT/ICD-10 coding required
• Scribe certification preferred
• Ophthalmic coding preferred

Physical Abilities

• Must be able to multi-task and work in a fast-paced environment.
• Work may require sitting for long periods of time
• Requires manual dexterity sufficient to operate a keyboard, calculator, telephone, and other office equipment.

Note

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.