Job Description
Job Description
About Us:
We are a well-established medical practice known for our relaxed environment and highly skilled team. We prioritize efficient, compassionate patient care, and we’re seeking an experienced Medical Biller who is organized, detail-oriented, and committed to accuracy and professionalism.
Job Overview:
As our Medical Biller, you’ll be responsible for managing the full billing process, ensuring accurate and timely submission of claims to insurance companies and government programs. Your role will involve preparing claims, reviewing patient records, monitoring billing compliance, and maintaining patient accounts. This position requires a solid understanding of medical terminology, ICD-10 and CPT coding systems, and proficiency in eClinicalWorks (eClinicals). Proficiency in Spanish is required.
Primary Responsibilities:
- Billing & Claims Submission: Prepare and submit accurate claims to insurance companies, government programs, and vision plans via eClinicalWorks. Ensure timely filing to avoid delays and denials.
- Record Review: Review patient records for completeness and accuracy prior to billing, analyzing medical records to identify billable services and correctly sequence diagnostic and procedure codes in compliance with payer requirements.
- Follow-Up & Denial Management: Follow up on unpaid claims, investigate discrepancies, correct errors, and rebill or appeal as necessary to maximize revenue.
- Documentation & Reporting: Maintain detailed records of billing activities, payments received, and outstanding balances; prepare periodic reports identifying any billing issues or unpaid charges.
- Communication & Collaboration: Collaborate with physicians and staff to ensure accuracy of billing data; communicate effectively with patients and insurance companies to resolve billing disputes and answer inquiries.
- Regulation & Compliance Updates: Stay updated on coding regulations, payer requirements, and any changes affecting reimbursement to maintain compliant billing practices.
Additional Responsibilities (Cross-Trained Duties):
- Check patients in and out, answer phones, and handle scheduling as needed.
- Obtain surgical benefits and authorizations, quote deductibles/copayments, and verify insurance acceptance.
- Post charges for clinic visits and procedures, process patient payments, and perform daily bank deposits.
- Prepare and maintain accurate electronic health records.
Essential Knowledge, Skills, and Abilities:
- Medical & Vision Billing Knowledge: Knowledgeable in medical and vision billing, coding, claim filing, and collections.
- Proficient in Coding Systems: Familiarity with ICD-10, CPT, and HCPCS Level 1 & 2 codes.
- Appeals and Compliance Knowledge: Ability to write clear and concise appeals; knowledgeable in compliance requirements for Medicare, Medi-Cal, VA, Tricare, and third-party payers.
- Technical Proficiency: Skilled in eClinicalWorks, Microsoft Word, Excel, and basic office equipment. Typing speed of at least 45 wpm.
- Bilingual (Spanish) Communication: Fluent in Spanish for patient and team interactions.
- Attention to Detail: Strong organizational skills, attention to detail, and the ability to multitask in a fast-paced environment.
- Customer Focus & Professionalism: Ability to handle patient billing concerns with empathy and professionalism, ensuring patient privacy in accordance with HIPAA.
Physical Requirements:
- Light physical effort (lift/carry up to 25 lbs.).
- Occasional reaching, bending, and crouching.
- Prolonged periods of standing, sitting, and walking, with frequent computer work and phone use.
Qualifications:
- Education: High school diploma or equivalent.
- Experience: Minimum two years of medical billing experience, including coding, collections, and insurance processes.
- Additional Experience: Prior ophthalmology or optometry billing is a plus.
Why Join Us?
- Competitive salary with comprehensive benefits.
- Work in a supportive, patient-centered environment alongside a collaborative and skilled team.
- Opportunity to contribute significantly to the efficiency of our healthcare services.