Description

The Billing Coordinator, Ophthalmology reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities:

• Assists patients with billing and insurance related matters including communicating with patients regarding balances owed and other financial issues and facilitating collection of balances owed.
• Educates patients about financial assistance opportunities, insurance coverage, treatment costs, and Ophthalmology clinic billing policies and procedures.
• Collaborates closely with physicians and technicians to understand treatment plans and determine costs associated with these plans.
• Works closely with the staff on managed care and referral related issues and communicates findings to patients.
• Coordinates the pre-certification process with the clinical staff.
• Handles billing inquiries received via telephone or via written correspondence.
• Responsible for thoroughly investigating and understanding financial resources or programs that may be available to ophthalmology patients and educating staff and patients about these programs.
• Conducts pre-certification for appropriate tests or procedures and facilitates the process with managed care and the clinical team.
• Documents all information and authorization numbers in Epic and acts as a liaison for follow-up related to pre-certification.
• Performs activities and responds to patient inquiries related to billing follow-up.
• Requests necessary charge corrections.
• Identifies patterns of billing errors and works collaboratively with department manager and outside entity to improve processes as needed.
• Performs administrative activities and projects.
• This role may support additional projects, perform administrative tasks, and other duties as assigned.
• AA/EOE.

Qualifications

Required:

• 1-3 years of experience with physician/healthcare billing/registration/accounting and/or overall patient financial counseling.

• High school diploma or GED equivalent.
• Knowledge of insurance billing procedures, ICD and CPT coding.

• Expertise with third party payors.
• Computer skills: Systems utilized include Microsoft Office (specifically Excel)

Preferred:

• Associate’s degree from an approved Health Information Management program or CCSP.
• Bachelor’s degree.
• Experience with EPIC/EMR

Equal Opportunity

Addendum 1: Ophthalmology Clinic

• The Billing Coordinator, Ophthalmology is responsible for assisting patients with billing and insurance matters related to specialized services rendered in the clinic. This position will require a thorough understanding of the specific ophthalmic procedures performed within the ophthalmology clinic, and will use that knowledge in order to seek maximum reimbursement on behalf of the organization through various external and internal programs and payment plans. Additionally, this person will assist patients with payment of their bills by establishing payment plans when complete insurance coverage is not available. This position will also be responsible for providing education and support to patients and the Ophthalmology staff regarding financial policies. The Billing Coordinator will also perform charge audits to ensure proper documentation and coding are utilized to optimize reimbursement/RVUs.

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.