Medical Billing Clerk

Job ID: 10-2022-206

JOB DESCRIPTION

Specialty Eye MDs is a large and comprehensive Ophthalmology practice in New Jersey. We are the recognized leader in vision care treating adults and children. We are seeking a detail-oriented; 

JOB TITLE: MEDICAL BILLING CLERK

POSITION SUMMARY:

The MEDICAL BILLING CLERK performs critical functions such as accurately coding and billing healthcare claims in order to obtain reimbursement from insurance companies and other providers, ensures clean billing process, follows-up on accounts that require further evaluation and works with others in a team environment.

PRINCIPAL DUTIES AND RESPONSIBILITIES: 

• Reviews medical record documentation to identify all services provided by physicians
• Report missing or incomplete documentation
• Assign appropriate procedure codes and modifiers to accurately report the physician services provided to patients
• Assign appropriate diagnosis codes to accurately support the need for each physician service
• Accurate claim entry and submission
• Post payments to patient accounts
• Process insurance or patient refunds
• AR aging and collection activities
• Resolve billing issues identified by insurance payers and patients
• Investigate and resolve payment denials and process appeals in a timely manner
• Serve as a resource regarding insurance resolutions and coding questions
• Work with the registration department to ensure proper information is received for claims processing
• Follow coding guidelines and legal requirements to ensure compliance with Federal and State regulations
• Performs additional duties assigned by the Practice Manager. 

Medical Coder/Biller Requirements and Qualifications

• High school degree, Bachelor’s or Associates degree.
• Valid Medical Coding Certificate; CPC (Certified Professional Coder) by AAPC
• Maintain coding certification and completes training /CEUs as required
• Two (2) years of medical coding & billing experience
• Experience with insurance terminology, products, notices and explanation of reasons for payment, adjustment, denial and/or uncovered charges of a medical claim
• General understanding of medical terminology, anatomy and physiology
• Ability to work independently or as an active member of a team
• Strong computer skills as it relates to data entry, utilizing insurance applications/websites, Microsoft Office Suite and electronic medical record software,
• Detail-orientated and highly organized
• Ability to multitask, prioritize, and manage time efficiently
• Excellent verbal and written communication skills
• Ability to evaluate processes and make suggestions for improvement 

This job description is not intended to be all-inclusive and may be expanded to include other duties and responsibilities that management may deem necessary from time to time.

 Job Type: Full-time, Hourly

PREFERRED EXPERIENCE: 

• Prior Medical Billing & Coding experience in an Ophthalmology office.
• Customer service.