Ophthalmology Medical Billing Specialist

About us:

Optivate is a leading provider of healthcare technology software solutions purpose-built for ophthalmologists and eye care specialists. The company's solutions, which include EMR, practice management, patient engagement, image management, and RCM services are designed to streamline clinical documentation workflows and improve daily practice efficiencies for eye care professionals.

Job Summary:

We are seeking a detail-oriented and organized individual to join our team 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.

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 the client as requested or needed

Maintains up-to-date knowledge of industry knowledge/changes

Follow established company policies and procedures

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 quickly

What We Offer:

Competitive base salary

Comprehensive benefits including medical, dental, vision, and 401(k)

Generous paid time off and holiday schedule

Opportunity to grow within a mission-driven and innovative healthcare tech company