What are the responsibilities and job description for the Ophthalmology Claims Processor & Clinical Support Specialist position at East Alabama Eye Clinic?
Join Our Team at East Alabama Eye Clinic!
At East Alabama Eye Clinic, we are committed to delivering exceptional Eye Care and outstanding service to our Patients. We’re seeking a dynamic, versatile individual to join our team.
Job Title: Ophthalmology Claims Processor & Clinical Support Specialist
Location(s): Principally Based in Anniston AL
Job Type: Full-Time
Schedule: Monday – Friday, 7:30 AM – 4:30 PM (Hours may vary slightly depending on clinic needs and location)
Pay: Competitive, Based on experience
Role Overview:
We are seeking a versatile Ophthalmology / Eye Care Claims Processor & Clinic Support Specialist to join our practice. This unique dual-function role primarily manages our specialized ophthalmic revenue cycle while occasionally cross-training to provide vital hands-on assistance to our doctors in the clinic when needed.
Key Primary Components (Revenue Cycle Management):
- Process Claims: Code and submit clean electronic and paper claims specifically tailored to eye care guidelines.
- Process Third-Party Payments: Post and reconcile insurance payments, manage Electronic Remittance Advices (ERAs), and ensure exact balance sheet accuracy.
- Work Collections: Manage outstanding accounts receivable (A/R) aging reports, contact patients / payors regarding past-due balances, and arrange compliant payment.
- Insurance Pre-Certification: Secure mandatory prior authorizations for specialized ophthalmology procedures, surgical injections, and advanced diagnostic imaging before care is delivered.
- Investigate & Re-process Rejected Claims: Promptly analyze, fix, and resubmit denied, rejected, or underpaid claims through targeted appeals.
- Assist with Periodic Payor Audits: Compile, organize, and securely deliver required medical documentation to insurance companies during periodic payor audits.
Key Supplementary Components (Clinical Support):
- Periodic Clinic Support: Cross-train to fill in seamlessly for clinical staff during high-volume periods or staff absences.
- Assist the Doctor: Directly assist the ophthalmologist or other eye care specialist with basic patient workups, documenting exam notes, and prepping exam rooms.
Ideal Qualifications & Skills:
- Experience: 1–3 years of experience in medical billing, with a strong preference for Ophthalmology or Optometry billing.
- Clinical Adaptability: Willingness to train in basic clinical tech and optician skills; prior experience as an ophthalmic or eye care technician is a major plus.
- Specialized Knowledge: Familiarity with vision plans (e.g., VSP, EyeMed) versus major medical insurance guidelines, alongside standard CPT and ICD-10 coding.
- Technical Skills: Proficiency with practice management software and electronic health records (EHR).
Benefits We Offer:
- Competitive pay
- Health insurance
- Dental Insurance
- 401(k) with 401(k) matching
- Employee discounts on eyewear and services
- Paid time off
Join a team where your skills and dedication make a difference in the lives of our Patients. Be part of a supportive, professional environment that fosters growth and success.
Apply now to start your rewarding career with East Alabama Eye Clinic!
Pay: $15.00 - $18.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Paid time off
- Retirement plan
Work Location: In person
Salary : $15 - $18