Billing and Accounts Receivables Specialist

Southern Vitreoretinal Associates (SVA) is seeking a BILLING and ACCOUNTS RECEIVAVABLES SPECIALIST to join our Tallahassee, FL team.  SVA is an Ophthalmology practice that specializes in retina care. We have six offices and six physicians.  The ideal candidate will thrive in a fast-paced environment, exhibit exceptional attention to detail, and demonstrate the ability to manage multiple priorities with urgency and accuracy. Under general supervision of the Assistant Business Office Manager, the BILLING and ACCOUNTS RECEIVAVABLES SPECIALIST responsibilities will include obtaining prior authorizations, working outstanding insurance balances for services rendered by SVA, ensuring timely reimbursement.  The Billing and Accounts Receivables Specialist is responsible for researching, analyzing all open claims and any unpaid insurance balances, resolving outstanding issues in a timely manner. Individual will also be responsible for assisting with authorizations, payments and patient communications as necessary.  

PRIMARY AREAS OF RESPONSIBILITIES: The duties identified below are the essential functions of the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned that align with the summary of this position.

1. Obtain authorizations for office visits and physician administered medications
2. Extensive A/R work, claim denials, submitting appeals, checking claim statuses, confirming payments match fee schedules, calling insurance companies  
3. Payment posting to accounts receivable system from all insurance carriers, patients, and funding companies 
4. Obtaining insurance eligibility and benefits information with all major insurance companies
5. Able to explain patients benefits to patients in a clear and professional manner
6. Obtain authorizations for office visits and physician administered medications
7. Calculate patient amount due and contact patient via telephone
8. Review schedules prior to date of service
9. Will approve scheduled and same day injections after checking for necessary authorizations and communicate such to clinical staff
10. Maintains excellent communication skills and interpersonal skills with physicians, patients, and co-workers
11. Working with Patient Assistance Programs to enroll patients and the ability to explain these programs to patients
12. ICD -10 / CPT Code knowledge
13. Knowledge of how to read and interpret explanation of benefits
14. Payment posting to accounts receivable system
15. Review next day balances

ACCOUNTABILITIES:

1. Facilitates the rapid and successful conversion of patient revenue into cash, minimize debt, improve cash flow and manage overall health of the Clinic’s receivables.
2. Meets or exceeds Key Performance Indicators (KPI’s) that are relevant to the work assigned so that SVA achieves best practice measures for Revenue Cycle.

EXPECTATIONS:

1. Reinforces and abides by SVA’s core values. Ensures direct reports abide by the same core values
2. Ensures high level of customer service, compassionate, patient-centered care to patients.
3. Collaborates across the organization to develop, implement, and maintain processes that positively impact the revenue cycle.
4. Understands and complies with all laws, rules, regulations, policies, and procedures applicable to the position.
5. Utilizes a variety of office technology, to capture and document services provided, ensuring an accurate billing record.
6. Excellent written, verbal and presentation skills necessary to facilitate accurate communication with providers and staff, providing a consistent message.
7. This person must be willing to work on-site, in-office, NO REMOTE WORK will be available.

EDUCATION AND EXPERIENCE:

EXPERIENCE:

1. High School diploma or equivalent.
2. Billing experience, 1 year minimum required
3. Accounts Receivable Experience, 6 months minimum required
4. Strong understanding of private insurance rules and regulations
5. Excellent organizational skills and keen attention to detail 
6. Computer literacy with medical accounts receivable programs and internet-based websites
7. Able to follow directions quickly and efficiently with varying workloads and interruptions. 
8. Must be able to work well under pressure and deal with coworkers in a courteous and cooperative manner. 
9. Good communication skills
10. Excellent customer service 

PREFERRED QUALIFICATIONS:

1. Proficiency in reviewing and interpreting Explanation of Benefits (EOBs) is a plus.
2. Knowledge of medical billing processes and terminology is a plus.
3. Excel skills, including formulas, pivot tables, and data analysis is a plus.

Working Environment: 

1. Fast-paced, high-energy environment requiring attention to detail and quick decision-making.
2. Must be able to manage multiple tasks simultaneously while ensuring quality and patient satisfaction.
3. Prolonged periods of sitting and working on computers
4. Full-time position: Work hours are Monday through Friday. Typically,8:00am – 5:00pm with one night closing until 6:00pm on a rotational basis.
5. This person must be willing to work on-site, in-office, NO REMOTE WORK will be available.

Why Join Us:

This position offers unparalleled opportunities to learn and grow within a supportive team environment. You'll be challenged daily, allowing you to expand your skill set and make meaningful contributions to our patients' well-being. If you're ready to take your career to the next level and thrive in a role that values empathy and expertise, we invite you to apply and become part of our dynamic team today.

Pay and Benefits:

• Starting pay is $16-19 per hour
• Full time employees offered Health with HSA, Vision, EAP, Dental, Life Insurance, 401K matching, Profit Sharing, PTO and Paid Holidays

*EEOC and ADA Disclaimer: Southern Vitreoretinal Associates is an Equal Opportunity Employer. Employees must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodation will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. Southern Vitreoretinal Associates retains the right to change or assign other duties to this position.