Remote Billing Ops Associate: Clean Claims & Reimbursements

Colonial Group; San Antonio (TX); Remote; USD 30,000 - 38,000; Full time

Job summary

Visionworks is seeking a Billing Specialist to ensure accurate, compliant, timely billing and reimbursement for professional vision and medical exams across vision insurance payers. This remote, full-time role involves submitting claims, posting payments, handling adjustments, and pursuing follow-up and collections in a managed care environment.

You will work with store teams to ensure proper demographics and authorizations, analyze denials, process appeals, and generate patient balance

Qualifications

• Zero to one (1) years of experience in medical insurance claims billing preferred.
• Proficient in MS Excel and Word.
• 10-Key by touch.

Responsibilities

• Prepare and submit clean claims to various insurance companies either electronically or by paper in accordance with payer guidelines and contract requirements.
• Analyze and correct first pass rejected claims for completeness and accuracy of information for second pass clean claim submission.
• Research and perform all primary and secondary billing claim status follow up activities for assigned insurance plans.
• Review, evaluate and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation.
• Research and recommend any third party customer account adjustments and/or write-offs to Manager based upon collectability of account.
• Support and assist store associates with ensuring all proper customer demographic and authorizations are present for clean claim submittal to insurance carriers for accurate claims processing and payment.
• Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner.
• Generate and submit monthly patient balance due statements to customers as dictated by the explanation of benefits received from their insurance carrier.

Skills

MS Excel

MS Word

10-Key by touch

Verbal communication

Written communication

Education

High School Diploma or GED

Job description

Visionworks is seeking a Billing Specialist to ensure accurate, compliant, timely billing and reimbursement for professional vision and medical exams across vision insurance payers. This remote, full-time role involves submitting claims, posting payments, handling adjustments, and pursuing follow-up and collections in a managed care environment.

You will work with store teams to ensure proper demographics and authorizations, analyze denials, process appeals, and generate patient balance