Ophthalmology Denial Revenue Cycle Analyst

A large Ophthalmology group in the South Florida area is looking for an experienced and talented billing professional to join the virtual administrative office. The position would entail review and process of health care billing, appealing insurance claims in accordance to latest regulations and answering patient business inquiries among other duties. The position is remote but requires residency in the state of Florida. Minimum required experience of Medical Billing experience or combined education-not an entry level role.

OVERVIEW:

The Denial Analyst is responsible for performing tasks related to the health care billing process by reviewing, submitting, and properly appealing claims in compliance with the latest insurance regulations and procedures.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

· Processes refunds in accordance of the Refund Policy.

· Maintains strict confidentiality and adhering to HIPAA guidelines/ restrictions.

· Answers incoming phone calls from patients, insurance companies, and EPF care centers.

· Identifies and resolves patient billing questions. Properly documents patient’s account of all actions taken during and after call.

· Posts LLC & LLP remittances, including $0 payments, to complete reconciliation of claim using the appropriate reason code(s). Flag claims that require follow up.

· Follows up of insurance claim status using policy & procedures including Navicure denials and insurance correspondence.

· Completes accounts receivable report processed at a minimum of 50 claim status/claim appeals a week.

· Reviews and follows up of insurance claim rejections and inaccurate payments. Documents each account using the standardized format.

· Brings accounts to zero balance by collecting money, applying credit adjustments, processing refunds, and small balance write offs.

· Processes assigned correspondence and denials within a 30 day turnaround time.

· Participates in annual educational seminars and training.

· Processes returned mail by reviewing patient’s driver’s license in chart, Phreesia portal and communication with referring physician.

SKILLS REQUIRED

· Excellent computer skills in a Microsoft Office environment-EXCEL is a must!

· Strong English written and verbal communication.

· Strong attention to detail and ability to thrive in a PAPERLESS remote work setting.

· Internet Software; payer portal knowledge, i.e. Availity, Unitedhealthcareonline.com, cignaforhcp.com, etc.

· Adobe acrobat reader proficiency, printing to PDF, combining and extracting files, etc.

· Bilingual-Spanish is a plus

For immediate consideration, please submit your resume.

**Eye Physicians of Florida, LLP is an Equal Opportunity Employer & Drug Free Workplace**

Job Type: Full-time

Pay: Up to $20.00 per hour

Benefits:

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

Work Location: Remote

Salary : $20