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Billing and Claims Coordinator

2 months ago

Mason, Ohio, United States Russell Tobin Full time

Position – Billing and Claims Coordinator

Location – Remote

Duration – Long-term Contract

Compensation - Competitive Rate

Position Overview:

We are looking for a meticulous and skilled Billing Specialist to become a vital part of our Eye Care division. This position plays a key role in maintaining the precision and effectiveness of our billing operations associated with vision care. The ideal candidate will possess a robust background in medical billing and insurance protocols, complemented by exceptional communication and analytical abilities.

Key Responsibilities:

  • Client Interaction: Engage in daily communication with both internal and external stakeholders via phone and email to investigate and resolve billing discrepancies efficiently. Provide regular updates to management regarding the status of issues.
  • Data Reporting & Analysis: Create and present reports, analyze data to uncover trends, forecast outcomes, and propose solutions to ensure accurate invoicing of premiums and claims.
  • Billing Analysis: Examine billing patterns, conduct root cause analysis, and address client setup challenges. Suggest enhancements for process optimization.
  • Process Enhancement: Identify clients at risk, verify billing procedures, and recommend adjustments to systems and processes to improve operational efficiency.
  • Quality Auditing: Review new or altered setups to guarantee precise invoicing and data management.
  • Subject Matter Expertise: Serve as a primary resource for billing processes and client onboarding initiatives. Facilitate training sessions on billing and invoicing, including updates to business practices.

Top Mandatory Qualifications:

  1. Medical Terminology Proficiency: Knowledge of medical terminology relevant to vision care.
  2. Insurance and Billing Knowledge: Familiarity with various insurance plans, billing methodologies, and coding systems (e.g., ICD-10, CPT).
  3. Detail Orientation: Commitment to accuracy in billing, coding, and documentation.
  4. Technical Skills: Proficient in billing software, electronic health records (EHR), and healthcare management systems.
  5. Effective Communication: Strong ability to communicate with healthcare providers, insurance entities, and patients.

Desirable Attributes:

  1. Analytical Problem-Solving: Skill in addressing billing discrepancies and navigating insurance claim denials.
  2. Reporting and Data Analysis: Experience in generating reports and analyzing data for trend identification and process refinement.
  3. Training and Development: Capability to lead and conduct training sessions on billing and invoicing.

Qualifications:

  • Education: Bachelor’s Degree in a relevant field or equivalent experience.
  • Experience: At least 3 years of experience in billing and insurance processes or 5+ years of related experience.