Medical Billing Specialist OPHTHALMOLOGY EXP REQ

Milwaukee Avenue Eye Center is seeking a detail-oriented and motivated Full-Time Ophthalmology Billing Specialist to join our supportive, patient-focused team. If you have a passion for accuracy, a strong understanding of medical billing, and thrive in a collaborative environment, we’d love to meet you!

Qualifications/Skills:

Required:

• Strong knowledge of medical billing and coding procedures with specific experience in ophthalmology
• Proficiency in billing software and electronic health records (EHR) systems
• Excellent attention to detail with high accuracy in data entry and claim submission.
• Professional communication skills for interacting with physicians, patients, insurance representatives and staff
• Strong organizational skills with the ability to manage multiple tasks and meet deadlines.
• Demonstrates working knowledge of Medicare Local Coverage Determinations (LCDs) and NCCI edits, applying payer policies to ensure appropriate coding, documentation, and reimbursement compliance
• Knowledge of HIPAA, OSHA, standards and compliance

Claims Processing

• Submit electronic and paper claims to Medicare, Medicaid, and commercial payers.
• Review clearinghouse rejections and correct claims for resubmission.
• Verify claim filing indicators and payer requirements for accurate submission.

Denial Management

• Investigate and resolve claim denials related to coding, medical necessity, authorization, or documentation.
• Prepare and submit claim corrections, reconsiderations, and appeals when appropriate.
• Track payer trends and report recurring issues affecting reimbursement.

PREFFERED:

• Experience with ophthalmology or optometry billing.
• Knowledge of procedures such as cataract surgery, visual field testing, OCT, and eyelid procedures.
• Experience working with Medicare, Medicare Advantage, Medicaid, and commercial insurance plans.

Job description:

• Post charges and submits claims daily
• Post medical/vision insurance payments
• Ensure compliance with healthcare regulations and guidelines during the billing process.
• Manage accounts receivable and follow up on outstanding payments.
• Collaborate with medical staff and administrative staff to resolve billing related discrepancies or issues.
• Investigating and resolving billing errors and discrepancies
• Maintain organized records of all billing transactions and communications.
• Communicate with patients and insurance companies regarding payment and collections
• Any other billing/administrative duties assigned by billing manager

Typical Hours: Monday-Thursday 8am-5pm and Friday 8 am-3:30 pm.

Expected hours: 35-40 hrs per week

Work Location: In person

Job Type: Full-time

Pay: $20.00 - $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee discount
• Flexible schedule
• Health insurance
• Paid time off

Experience:

• Medical billing: 3 years (Required)
• Ophthalmology: 3 years (Required)

Ability to Commute:

• Niles, IL 60714 (Required)

Work Location: In person

Salary : $20 - $23