Medical Biller (Long-Term Temporary)

Job Title: Medical Biller (Long-Term Temporary)

Pay: $22–$24 per hour
Schedule: Monday–Thursday, 9:00 AM–5:00 PM (PST); minimum 20 hours per week within this window
Location: Onsite (Kent, WA)

Start Date: Immediately
Employment Type: Long-term temporary / part-time (3-6 Months)

About the Role

Simply Great Staffing is seeking a detail-oriented Medical Biller with hands-on optometry coding experience to support end-to-end revenue cycle activities—submitting clean claims, managing accounts receivable, driving denial resolution/appeals, and assisting with patient scheduling and occasional phone reception. The ideal candidate thrives in a fast-paced clinic environment, understands Medicare Advantage payer policies, and consistently delivers high first-pass claim acceptance rates.

Key Responsibilities

Coding & Charge Capture

• Accurately code optometry encounters using ICD-10-CM, CPT, and HCPCS guidelines (e.g., comprehensive/ intermediate eye exam codes, diagnostic imaging, treatments).
• Review provider documentation for completeness; query clinicians to resolve discrepancies before submission.
• Post charges, modifiers, place of service, and attach required documentation (e.g., authorization, medical necessity).

Claims Submission & Reconciliation

• Prepare and submit electronic claims via clearinghouse and payer portals; monitor rejections and correct within service-level timelines.
• Perform daily reconciliation of batches/EOBs/ERAs, post payments, adjustments, and balance transfers.

Denials, Appeals & A/R Management

• Work aged A/R (0–30/31–60/61–90/90 day buckets) to reduce days outstanding.
• Investigate denials (eligibility, coordination of benefits, prior auth, medical necessity, bundling, NCCI edits, modifier issues) and file timely, well-supported appeals.
• Track trends by payer and reason code; recommend preventive fixes (coding edits, documentation prompts, front-end eligibility checks).

Medicare Advantage Expertise

• Verify eligibility, benefits, and plan specifics; confirm authorizations/referrals; apply MA billing rules (e.g., network requirements, cost-share, pre-certs).
• Adjust workflows to payer-specific guidelines; maintain current knowledge of MA updates impacting optometry services.

Patient Scheduling & Front Office Support

• Appointment Making: schedule/confirm patient visits; coordinate recalls; reschedule as needed to optimize provider and diagnostic slots.
• Occasional Phone Reception: answer inbound calls, route messages, provide billing explanations, and take payments professionally and empathetically.

Compliance & Documentation

• Maintain HIPAA privacy/security standards, safeguard PHI in all workflows.
• Follow clinic policies, federal/state regulations, and payer contracts; maintain accurate audit-ready records.

Required Qualifications

• Direct experience coding optometry services and submitting optometry claims.
• Demonstrated denials/appeals success with commercial and Medicare Advantage plans.
• Proficiency with medical billing software, clearinghouses, and payer portals.
• Working knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and common optometry documentation requirements.
• Strong Excel/Google Sheets skills for aging reports and KPI tracking.
• Excellent communication (written/verbal) and customer-service mindset.

Preferred Qualifications (Nice to Have)

• Experience with optometry/ophthalmology EHR & PM systems (e.g., Eyefinity/OfficeMate, RevolutionEHR, Compulink, or similar).
• Familiarity with Epic, NextGen, Athena, or other enterprise platforms.
• Prior work in a high-volume clinic with multi-payer A/R.
• Bilingual skills are beneficial for patient financial communications.

Core Competencies

• Accuracy & Compliance: meticulous coder with strong documentation review.
• Ownership: proactively works aging and denial queues to resolution.
• Problem Solving: identifies root causes; implements preventive fixes.
• Collaboration: partners well with providers, technicians, and front office.
• Professionalism: calm, clear, and empathetic phone presence.

Tools & Systems You’ll Use

• Practice Management/EHR system (clinic standard), clearinghouse, and payer portals.
• Microsoft Excel/Google Sheets for aging, trend, and KPI dashboards.
• Phone system/voicemail and secure payment tools.
• Secure file management aligned with HIPAA.

Success Metrics (KPIs)

• Clean-claim rate: = 95% first-pass acceptance.
• A/R performance: steady reduction of >90-day buckets; maintain Days in A/R at target set by the clinic.
• Denial rate & turnaround: continued decline in denial percentage; timely appeal submissions within payer limits.
• Patient experience: positive feedback on billing explanations and scheduling interactions.

Work Environment & Physical Requirements

• Onsite, professional clinical setting; extensive computer and phone work.
• Ability to sit, type, and speak on the phone for extended periods; handle occasional front-desk support.

Background & Confidentiality

• Employment may be contingent on background check(s) per clinic policy.
• Strict adherence to HIPAA and clinic confidentiality standards is required.

Equal Opportunity Statement

We are an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic.

About Simply Great Staffing:

Simply Great Staffing is a leading staffing agency dedicated to connecting talented individuals with top companies. We specialize in providing personalized staffing solutions to meet the unique needs of our candidates & clients.

Email: Resumes@simplygreatstaffing.com OR Apply at: www.simplygreatstaffing.com

Ready to take the next step in your career? Apply today and join our team in Kent, WA!