Billing Specialist

Title: Billing Specialist

Department: Finance, Revenue Cycle Management

Reports to: Revenue Cycle Management Lead

FLSA: Non-Exempt (Hourly)

Job Type: Full-time, 40 hours per week. On-site.

About Us:

At Retina Specialty Institute and Southern Eye Group we are dedicated to preserving and improving the gift of sight. As growing leaders in the field of ophthalmology, we utilize cutting-edge technology and the latest advancements in healthcare to provide exceptional care to our patients. Our commitment to excellence drives us to prioritize patient care above all else, ensuring that each patient receives the highest standard of treatment. We believe that by saving sight, we are not only preserving vision but also enhancing lives. Join our team and be a part of our mission to make a difference in the lives of our patients every day.

General Purpose of Job/Summary:

We are seeking a detail-oriented and proactive Billing Specialist to join our team. The Billing Specialist is responsible for managing the full scope of the revenue cycle process, including insurance verification, prior authorizations, billing, collections, and denial resolution, to support both patient care and the financial health of the organization. This role works closely with clinical and administrative teams to ensure accurate, timely, and compliant revenue capture. Candidates with comprehensive RCM experience and strong problem-solving skills are encouraged to apply.

Essential Duties and Responsibilities:

• Verify patient insurance eligibility and benefits prior to scheduled services.
• Obtain and document prior authorizations for services and medications as required by payers.
• Accurately process insurance claims and patient invoices in a timely manner.
• Review claims for completeness, accuracy, and compliance with payer requirements before submission.
• Monitor unpaid claims and proactively follow up with insurance companies or patients to resolve delays or denials.
• Investigate and correct billing errors or discrepancies, taking appropriate corrective actions.
• Post payments, adjustments, and denials accurately into the billing system.
• Communicate with patients to explain account balances, payment responsibilities, and answer billing questions.
• Collaborate with other departments to address patient account or insurance issues.
• Track and report on trends in denials or reimbursement delays to assist with process improvement.
• Maintain organized and accurate billing and authorization records, ensuring compliance with HIPAA and other regulations.
• Stay current on payer guidelines, coding rules, and revenue cycle best practices.

Qualifications:

• High school diploma or equivalent.
• Understands the full revenue cycle process, including insurance verification, authorizations, billing, and collections.
• Preferred: Associate's degree or higher; experience in ophthalmology or optometry; certifications related to medical billing or coding.

Required Skills & Abilities:

• Maintain a composed demeanor, pleasant attitude, and polished, professional appearance.
• Demonstrated proficiency with technology; familiarity with electronic medical records (EMR) systems, billing software, and Microsoft Office Suite.
• Will observe all company confidentiality requirements and HIPAA regulations to protect patient privacy and maintain HIPAA compliance.
• Friendly, helpful team player with a positive, customer-service attitude.
• Outstanding communication and interpersonal skills.
• Exercise good judgement and take initiative to properly address and resolve issues.
• Ability to prioritize and multitask without sacrificing accuracy.
• Dependable and punctual, with a strong attendance record.
• Organized and reliable, with excellent follow-through.
• Comfortable working both independently and as part of a team.

Offered Benefits:

• Competitive salary commensurate with experience.
• Health, dental, and vision insurance.
• Life insurance, disability coverage, and ancillary benefits offered.
• 401k eligibility with company match.
• Paid time off and holidays.
• Opportunities for professional development and certification.
• Friendly, upbeat, and supportive work environment.

Equal Opportunity Employer:

Retina Specialty Institute and Southern Eye Group are equal opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. It is the policy of our companies not to discriminate on the basis of age, color, sex, disability, national origin, race, religion, gender identity, sexual orientation, veteran status or any other characteristic protected by law.

Physical Requirements and Work Environment:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions to the extent the Company may do so without undue burden.

This position is primarily sedentary and requires prolonged periods of sitting and computer use in a fast-paced administrative setting. Occasional walking, reaching, or lifting of items up to 15 pounds may be necessary. Visual acuity sufficient for reading documents and using a computer is essential. Frequent phone and virtual communication with patients, insurance companies, and team members across the practice is required. Clear and professional verbal communication is essential. Work is performed on-site in a climate-controlled office environment with moderate noise levels.

Other Duties:

This job description provides an overview of key duties but is not all-inclusive. Responsibilities and tasks may evolve over time, and adjustments may be made as needed, with or without prior notice.

Job Type: Full-time

Pay: $ $22.00 per hour

Expected hours: 30 – 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Vision insurance

Work Location: In person