Medical Billing Specialist A/R

Position Summary

We are seeking a detail-oriented and organized individual to join Optivate's RCM division as a Medical Billing Specialist. In this crucial role, you will play a vital part in ensuring timely and accurate claim processing and financial health for our Company. You will be responsible for submitting claims to insurance companies, managing patient accounts, and resolving billing issues. This position requires strong analytical skills, attention to detail, and excellent communication abilities.

Key Responsibilities

• Submit claims electronically to insurance companies.
• Review and follow up on denied claims to ensure proper reimbursement. This includes but is not limited to; calling insurance payers, preparing appeals, resubmitting claims, and contacting patients.
• Generate and analyze reports on billing activity and identify areas for improvement.
• Research and resolve discrepancies in patient information and claims
• Identifies and reports unpaid/underpaid claim trends
• Post Payments as required to Accounts Receivable.
• Apply adjustments to patient accounts as appropriate.
• Research and resolve discrepancies in payment postings.
• Prepare and submit daily/weekly/monthly reports on payment activity as directed by management.
• Communicate effectively with other members of the team.
• Maintain a positive and collaborative working environment with other team members.
• Provides excellent customer services to patients and clients.
• Providers support to the client as requested or needed.
• Maintains up- to- date knowledge of industry knowledge/changes.
• Follow established company policies and procedures.
• Abides by HIPAA Policy.
• Other Duties as assigned.

Qualifications

• High school diploma or equivalent required
• Minimum of 3-5 years of experience in medical billing field required.
• Proficiency in medical coding systems (CPT, ICD-10- CM)
• Excellent understanding of healthcare insurance billing procedures.
• Strong analytical and problem- solving skills
• Excellent attention to detail and accuracy.
• Proficient in Microsoft Office Suite (Word, Excel).
• Ability to work independently and as part of a team.
• Excellent communication and interpersonal skills.
• Ability to meet deadlines.
• Strong organizational and time management skills.
• Ability to learn new software and procedures quickl

Why Join Optivate?

• Opportunity to help scale a rapidly growing ophthalmology-focused healthcare technology platform
• High-impact role with direct exposure to executive leadership and strategic growth initiatives