Medical Billing Specialist - Hybrid

Title: Medical Billing Specialist - Hybrid

Mandatory skills:

medical vision claims, medical coding,
Ophthalmology, Ophthalmology billing,
insurance carriers, claim requirements, insurance carrier filing, insurance carrier websites, claim status,
medical vision claims coding, billing, cash apply, patient billing statements,
Review medical claims, rejected claim reports, post claim payments, electronic health records, EHR,
overpayment refunds, claim balances

Description:

GENERAL FUNCTION:
The Medical Claims Coordinator is responsible for monitoring insurance carrier adjudication of medical claims for one or more doctor practices. Utilize an EHR system and clearing house to review and submit claims to multiple insurance carriers. Review open/unpaid claim balances and take timely action as required.

MAJOR DUTIES & RESPONSIBILITIES:
Review medical claims and transmit to the insurance carrier using the electronic health records (EHR) system and clearing house.
Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
Download insurance carrier evidence of benefits (EOBs) to post claim payments and denials in the EHR system.
Determine if denied claims can be adjusted and re-submitted to the carrier.
Review aging reports to research open balances and resubmit within insurance carrier filing limits.
Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
Initiate overpayment refunds to patients and repayments to insurance carriers when required.
Write-off open claim balances in the EHR system.
Serve as the point of contact for the practice regarding all vision and medical claims.
Support the corporate manager in maximizing claim collection rate.

BASIC QUALIFICATIONS:
3+ years of related work experience
Experience with medical vision claims and coding
Ability to prioritize handling of issues
Organizational skills and ability to multitask
Effective communication skills (verbal, written, listening, presentation)
Proven ability to identify issues and solve problems

PREFERRED QUALIFICATIONS:
Ophthalmology experience working in multiple doctor practices
Experience working with multiple insurance carriers and an understanding of their claim requirements

Specific Skills Needed:

Top 3-5 mandatory and/or minimum requirements:
Experience with medical vision claims coding and billing and cash apply experience

Top 3-5 desirable attributes/qualifications:
Ophthalmology billing experience

Multiple Locations:
4000 Luxottica Pl, Mason, OH 45040
6235 Cermak Rd., Berwyn, IL 60402

Notes:
Hybrid - 2 days onsite (Tuesday - Thursday on site) in office, 3 days WFH
Work Hours: 8-430pm 1/2 hour lunch
Temp to hire

VIVA USA is an equal opportunity employer and is committed to maintaining a professional working environment that is free from discrimination and unlawful harassment. The Management, contractors, and staff of VIVA USA shall respect others without regard to race, sex, religion, age, color, creed, national or ethnic origin, physical, mental or sensory disability, marital status, sexual orientation, or status as a Vietnam-era, recently separated veteran, Active war time or campaign badge veteran, Armed forces service medal veteran, or disabled veteran. Please contact us at for any complaints, comments and suggestions.

Contact Details :

VIVA USA INC.
3601 Algonquin Road, Suite 425
Rolling Meadows, IL 60008