Job
Description
Oversee and manage client medical and routine vision claims, ensuring compliance with CMS standards and optical billing regulations. Ensure timely and accurate processing of all client claims. Utilize the correct coding (e.g., ICD-10, CPT, HCPCS) to facilitate appropriate reimbursement. Collaborate with clients to resolve complex billing issues and discrepancies. Review insurance EOBs and work with clients to address claim denials or underpayments. Work closely with clients to educate and guide them on best billing practices for Optometry and Ophthalmology claims. Monitor the claims lifecycle, from submission to resolution, ensuring timely reimbursement for services rendered Qualifications : Strong knowledge of CPT, ICD-10, and HCPCS codes as they relate to Optometry, Ophthalmology, and routine vision services. Familiarity with Vision Plan Claims filing and optical-related billing. Ability to interpret and apply insurance company Explanation of Benefits (EOBs) effectively. Detail-oriented, analytical, and highly organized, with the ability to manage multiple priorities. Problem-solving skills to identify, research, and resolve billing issues independently. Strong written and verbal communication skills, with a focus on providing excellent customer service. Ability to quickly adapt to new software programs and systems. Excellent interpersonal skills and the ability to build strong relationships with clients. Oversee and manage client medical and routine vision claims, ensuring compliance with CMS standards and optical billing regulations. Ensure timely and accurate processing of all client claims. Utilize the correct coding (e.g., ICD-10, CPT, HCPCS) to facilitate appropriate reimbursement. Collaborate with clients to resolve complex billing issues and discrepancies. Review insurance EOBs and work with clients to address claim denials or underpayments. Work closely with clients to educate and guide them on best billing practices for Optometry and Ophthalmology claims. Monitor the claims lifecycle, from submission to resolution, ensuring timely reimbursement for services rendered Qualifications : Strong knowledge of CPT, ICD-10, and HCPCS codes as they relate to Optometry, Ophthalmology, and routine vision services. Familiarity with Vision Plan Claims filing and optical-related billing. Ability to interpret and apply insurance company Explanation of Benefits (EOBs) effectively. Detail-oriented, analytical, and highly organized, with the ability to manage multiple priorities. Problem-solving skills to identify, research, and resolve billing issues independently. Strong written and verbal communication skills, with a focus on providing excellent customer service. Ability to quickly adapt to new software programs and systems. Excellent interpersonal skills and the ability to build strong relationships with clients.
