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Ophthalmology LTD
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Medical Insurance Specialist (Medical Coder)
Ophthalmology LTD Sioux Falls, SD
Full Time 6 Months Ago
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Ophthalmology LTD is Hiring a Medical Insurance Specialist (Medical Coder) Near Sioux Falls, SD

Over the years, Ophthalmology LTD's name has become associated with the highest quality of comprehensive medical and surgical eye care. Highly trained ophthalmologists, as well as experienced optometrists, combine their considerable expertise to give each and every patient the best possible care. Ophthalmology LTD delivers treatment for cataracts, glaucoma, diabetic eye disease, as well as cornea transplants, oculoplastic surgery, retina surgery, vitreoretinal surgery, and pediatric eye care in Sioux Falls.

Ophthalmology LTD is looking to add a Medical Insurance Specialist (Coding Specialist) to our team. This person will be responsible for medical billing, coding, charge posting, insurance claims filing and follow-up, payment processing and reimbursement, and patient account management which includes answering patient and clinic staff inquiries, performing all aspects of collection activity with insurance payers and patients, and resolving billing issues. 

Job duties include:

  • Entering patient demographics and insurance coverage, verifying eligibility and benefits.
  • Assist with counseling patients in understanding medical benefits for services provided, self-pay obligations, and set up payment plans and agreements according to Ophthalmology Ltd. Patient Financial Policies. Electronic and paper claims submission, scrubbing, and monitoring claims and reports via clearinghouse software. Claims follow-up includes identifying errors and performing modifications as necessary for resubmission due to claim denials and/or inadequate reimbursement.
  • Perform charge entry of clinic and surgery charges, including monitoring and reviewing chart documentation, and assigning and appropriately linking CPT/ICD codes for claim accuracy, and monitoring posting reports for accuracy.
  • Payment posting (auto-post, ERA/EFT, and manual) includes contractual adjustments and monitoring of overpayments and refunds.
  • Patient Account Management to include in clinic or phone inquiries and counsel patients on out-of-pocket estimates, self-pay balances, and payment plans.
  • Daily and monthly reconciliation and balancing; performs internal audits of medical record documentation on a routine basis; communicate and educate doctors and staff as appropriate.

Education and Training requirements:

  • High School Diploma.
  • Prefer post-secondary education.
  • The ideal candidate will possess CPT and ICD coding knowledge in medical practice and has a thorough understanding of medical terminology and anatomy. Certification is encouraged: Certified Professional Coder, CPC or Ophthalmic Coding Specialist, OCS.
  • Minimum 2 years medical billing experience in a physician office setting with knowledge of various medical payer practices and insurance laws/guidelines (Medicare, Medicaid, Work Comp, VA, and other third-party payers). 2 years of computer experience with more than two practice management A/R and Electronic Medical Record Systems.

Please note this job description is not a complete listing of activities, duties, or responsibilities that are required for this job. Duties, responsibilities, and activities may change at any time with or without notice.

This position is a full-time, non-exempt role. Business office hours are Monday - Friday, 8 am - 5 pm. We offer a competitive compensation and comprehensive benefits package including health, dental, 401K, life insurance, AD&D, short and long-term disability, PTO, sick leave, paid holidays, and eye care benefits.

Job Summary

JOB TYPE

Full Time

POST DATE

09/07/2022

EXPIRATION DATE

09/20/2022

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