Medical Biller

Experienced Medical Biller – Ophthalmology

Location: Remote (U.S. payor experience required)
Schedule: Monday – Friday, 10:00 AM – 6:00 PM EST
Employment Type: Full-time (contract or employee depending on arrangement)

About the Role

We are seeking a highly experienced Medical Biller with extensive ophthalmology billing expertise to join our team. The ideal candidate will have several years of proven success in U.S. medical billing, excellent references, and a strong understanding of insurance payor policies, prior authorizations, and credentialing. This position requires consistent communication, responsiveness, and proactive problem-solving throughout the workday.

Key Responsibilities

• Full-Cycle Ophthalmology Billing
• Manage front- and back-end billing processes: eligibility & benefits verification, charge entry, claim submission, payment posting, appeals, and collections.
• Provide cost estimates to patients for office visits and surgeries.
• Monitor claims to ensure timely submission and payment.
• Insurance & Payor Communication
• Call insurance companies to resolve claim issues, verify coverage, and obtain prior authorizations.
• Handle credentialing and enrollment with new payors as needed.
• Confirm PCP referrals are valid and complete at least 3 days prior to scheduled appointments.
• Surgical & Clinical Coordination
• Prepare and update cost estimates for surgeries.
• Maintain and update surgery grids on Microsoft Teams.
• Track prior authorizations and ensure all documentation is complete before scheduled procedures.
• Compliance & Documentation
• Manage medical record requests and support audits.
• Ensure billing practices comply with U.S. healthcare regulations and ophthalmology-specific coding standards.
• Collaboration & Responsiveness
• Remain available for Google Meet/phone calls during working hours.
• Actively monitor Microsoft Teams and respond promptly to staff questions and requests.
• Work closely with the administrative and clinical teams to ensure smooth revenue cycle management.

Qualifications

• Experience: Minimum 5+ years of U.S. medical billing experience (ophthalmology strongly preferred).
• References: Must provide legitimate professional references.
• Technical Skills: Strong proficiency in EMR/EHR billing systems, payor portals, and claim submission platforms.
• Communication: Fluent in English (spoken and written), with excellent phone etiquette and professional demeanor.
• Technical Setup: Reliable IT system, fast internet connection, and a professional work environment for calls and meetings.
• Knowledge Base: In-depth understanding of U.S. medical billing regulations, ICD-10/CPT codes (especially ophthalmology), insurance benefits, and prior authorization workflows.

Preferred Attributes

• Prior experience with surgical and subspecialty ophthalmology billing.
• Strong organizational skills with attention to detail.
• Ability to work independently while staying responsive to the team.
• Comfortable with real-time problem solving and multitasking in a fast-paced environment.

Compensation

Competitive and commensurate with experience. Details will be discussed during the interview process.

Job Type: Full-time

Pay: ₹80,000.00 - ₹90,000.00 per month

Benefits:

• Paid time off