Responsible for timely billing of Ophthalmology professional, and facility claims for Clarus Eye Centre to ensure the reimbursement of claims from various insurance companies. Experience with Provider One Billing is required. The biller needs to have experience with the entire revenue cycle, Processing claims submission through a 3rd party intermediary, resolving claims rejections from payor or intermediary and have knowledge of ICD9 and/or ICD 10. Interprets third party requirements and appropriately bills for services within timely filing requirements. Will be Responsible for following CMS guidelines and remaining current on all internal and external billing policies related to Medicare and Medicaid. Will review claims for accuracy and resolve claims edits according to Medicare and/or Medicaid billing guidelines for timely payment. Based on error reports; make appropriate corrections to optimize the electronic claims submission process; and pursuing prompt follow-up efforts on aged accounts. Work with supervisor on the accounts receivable department to review problem accounts and identify the necessary action to be taken. Available to assist counting end of day cash closing and reconciliation

Key Job Functions include but not limited:

· Run bill selection daily and process bills and upload daily

· Transmit all electronic claims to insurances daily. Researches and resolves any electronic claim delays within 24 hours of exception report. Make sure secondary claims and rebills are completed timely

· Correct rejections daily to ensure timely filings are completed

· Understand payor requirements and special requirements

· Verification of appropriate CPT codes and modifiers

· Provider billing, ensuring proper organization and scheduling of billing

· Review claims for Medicare Part B, Medicare Secondary Payer claims, and Commercial and Managed Care insurance

· Adhere to facility, department, personnel and standard policies and procedures

· Works with coding system to ensure accuracy of data on claims

· Supports leadership with daily, weekly, monthly reporting needs as required

· Experience with HCFA 1500 and UB04 claim forms

· Billing and Accounts Receivable Representative

· Ensures confidentiality of medical records and patient information following HIPAA/HITECH guidelines. Ensures confidentiality of all passwords following HIPAA/HITECH guidelines.

· Take calls directed to the accounts receivable department from patients and/or insurance carriers. Discuss accounts with patients and provide whatever information is required by insurance companies to get claims paid.

· Daily payment entry from patients and insurance companies.

· Fill out Daily Claim and Denial Sheet. Closes the day prints and balances the daily work.

· Call for prior surgical authorization from insurance companies non-contracted

· Assist receptionist with overflow of incoming calls.

· Perform other duties, as required.

Qualifications:

· High school diploma or equivalent required.

· A minimum of one (1) years’ experience in professional and facility billing experience with knowledge of Medicare preferred, or related field, or any combination of education, training, or experience in a health care business office environment.

· Experience with insurance billing, computer, and business software programs (Excel) preferred. Including, Microsoft Office- word and outlook

· Excellent communications skills and professional demeanor is needed

· Detail oriented and possessing strong time management skills is necessary to manage multiple priorities in a fast-paced environment. May be required to work occasional flexible hours.

· Experience using Athenahealth is required.

PHYSICAL REQUIREMENTS:

· Requires dexterity to handle and count cash.

· Requires sitting for long periods of time with occasional bending required.

· Must be able to view and enter data into the computer for extended periods.

· Must be able to communicate through telephone.

The position in open to remote for Washington State residents only.

Job Type: Full-time

Pay: $21.50 - $24.30 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work setting:

• Hybrid work

Experience:

• Microsoft Excel: 1 year (Preferred)
• Billing through Athenahealth: 1 year (Required)
• Medical billing: 1 year (Required)

Ability to Relocate:

• Olympia, WA 98506: Relocate before starting work (Required)

Work Location: Hybrid remote in Olympia, WA 98506