Retina Associates of Orange County is a retina group of renowned board-certified Ophthalmologists who are fellowship-trained in vitreoretinal surgery and specialize in diseases of the retina, macula and vitreous.

Our doctors have a remarkable history that combines teaching at prestigious academic institutions in concert with excellence in patient care in the private practice setting. We are a growing practice located in Laguna Hills, Newport Beach, and Santa Ana.

The Medical Billing Manager is a full-time position responsible for overseeing the billing coding staff and making day-to-day decisions, understanding and coding all procedures within regulatory mandates, assisting with following up on insurance claims, and submitting appeals as needed. This position is responsible for directing and coordinating the overall functions of the billing and coding office to ensure the maximization of cash flow while improving patient, physician, and other customer relations. The Medical Billing Manager position requires the ability to produce and present detailed billing activity reports.

Responsibilities

• Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management

• Serves as the practice expert and go-to person for all coding and billing processes

• Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection

• Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues

• Follow up on claims using various systems, such as practice management, EHR, and clearinghouse.

• Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings

• Prepares and analyzes accounts receivable reports and weekly and monthly financial reports in concert with the Practice Administrator and Operations Manager. Collects and compiles accurate statistical reports

• Audits current procedures to monitor and improve the efficiency of billing and collections operations

• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements

• Participates in the development and implementation of operating policies and procedures

• Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures with the approval of the Director of Operations.

• Keep up to date with carrier rule changes and distribute the information within the practice

• Performs physician credentialing actions

• Travel between offices as needed.

QUALIFICATIONS FOR THE JOB

Education:

High school diploma

Experience:

Previous Medical Billing Manager experience.

Minimum 3 years of experience in medical billing.

Other:

• Able to stand and move throughout the office.
• Able to travel between the offices at the last minute.
• Exceptional problem-solving ability.
• Excellent communication skills are required.
• Coordination and organizational skills are required.

Job Type: Full-time

Salary: $60,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Retirement plan

Schedule:

• 8 hour shift

COVID-19 considerations:

All patients are required to wear masks during their visits. Common area surfaces are disinfected regularly.

Experience:

• Ophthalmology practice experience: 3 years (Required)
• Medical billing: 5 years (Required)
• Credentialing: 5 years (Required)

Job Type: Full-time

Pay: $55,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Retirement plan

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Application Question(s):

• Has at least 5 years of credentialing experience

Experience:

• Medical billing: 5 years (Required)
• Medical coding: 5 years (Required)

Work Location: In person