Medical Billing Specialist

5 days ago


Sioux Falls, South Dakota, United States Ophthalmology Ltd Full time
Job Summary

We are seeking a highly skilled Medical Billing/Insurance Specialist to join our team at Ophthalmology Ltd. This individual will be responsible for managing the entire revenue cycle, from medical billing and coding to insurance claims filing and patient account management.

Key Responsibilities:

  • Verify patient demographics and insurance coverage, and ensure accurate billing and coding.
  • Assist patients in understanding their medical benefits and self-pay obligations, and set up payment plans according to our patient financial policies.
  • Submit electronic and paper claims, and monitor claims and reports via clearinghouse software.
  • Perform charge entry, including monitoring and reviewing chart documentation, and assigning CPT/ICD codes for claim accuracy.
  • Post payments, including contractual adjustments and monitoring of overpayments and refunds.
  • Manage patient accounts, including in-clinic or phone inquiries, and counsel patients on out-of-pocket estimates and payment plans.

Requirements:

  • High School Diploma.
  • Prefer post-secondary education.
  • Ideal candidate will possess knowledge of CPT and ICD coding, and a thorough understanding of medical terminology and anatomy.
  • Minimum 2 years medical billing experience in a physician office setting, with knowledge of various medical payer practices and insurance laws/guidelines.


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