Retina-Vitreous Surgeons of Central New York could be your new home. We are seeking experienced medical billing candidates to join our team.
The Medical Billing & Accounts Receivable Specialist is responsible for managing the billing and reimbursement process, including follow-up and resolution of medical insurance claims that remain unpaid or have been paid incorrectly. This role ensures accurate claim submission, timely insurance follow-up, and proper documentation to maximize reimbursement while maintaining compliance with insurance regulations and HIPAA standards.
This position plays a critical role in the revenue cycle by ensuring claims are processed correctly, patient balances are accurate, and patient statements and refund requests are carefully reviewed for accuracy prior to release.
This is an in-office position located in Liverpool, NY (Not a remote job).
The ideal candidate is detail-oriented, experienced in working with multiple insurance carriers, and able to manage accounts efficiently in a fast-paced healthcare environment while maintaining a high level of accuracy and organization.
Essential Job Duties and Responsibilities: (Additional duties may be assigned)
· Follow up on unpaid or underpaid claims with insurance carriers to ensure timely reimbursement.
· Research claim denials and determine appropriate corrections or appeal actions.
· Submit appeals and supporting documentation to insurance companies when required.
· Monitor aging reports and prioritize accounts based on timely filing limits and payer policies.
· Scrub and review patient statements for accuracy prior to release, ensuring all charges, payments, adjustments, and insurance activity are correctly reflected.
· Review patient and insurance refund requests for accuracy prior to processing to ensure balances and adjustments are correct. Ensure refunds comply with practice policies and payer regulations.
· Respond to patient inquiries regarding billing questions, insurance coverage, and account balances.
· Assist patients in understanding Explanation of Benefits (EOBs) and financial responsibility.
· Process patient payments and ensure proper application to accounts.
· Verify insurance eligibility and benefits when needed.
· Maintain detailed and accurate account notes and billing documentation.
· Ensure compliance with HIPAA regulations and payer billing requirements.
· Follow established revenue cycle policies and procedures.
- Performs other related duties as assigned.
Education and Experience:
- HS diploma or GED required
- Minimum of three (3) years of medical billing or revenue cycle experience
- Strong understanding of insurance billing, claim follow-up and denial management
- Experience with ICD-10 and CPT coding preferred
Equipment, Machines and Software Used:
Ability to operate a computer, printer, telephone, copier/fax machine and postage meter. Computer Software: Nextech, MDI and Microsoft Office including Outlook, Excel and Word.
Knowledge, Skills, and Abilities:
· Strong computer proficiency including data entry, spreadsheets, and reporting tools
· Knowledge of HIPAA regulations and compliance standards
· Ability to calculate figures such as percentages, discounts, proportions, and interest
· Excellent verbal and written communication skills
· Strong organizational and multitasking abilities
· Effective problem-solving and analytical skills
· Ability to work in a fast-paced medical office environment
· Detail-oriented with strong record-keeping abilities
· Ability to compile and analyze data to prepare reports
· Strong interpersonal skills and the ability to work collaboratively with staff at all levels
· Ability to maintain patient confidentiality
· Professional demeanor and appearance
Physical and Mental Requirements:
Ability to sit, stand, walk, talk, hear, and perform repetitive hand and wrist motions
Ability to bend, crouch or kneel when necessary
Ability to exert:
Up to 30 pounds occasionally
Up 10 pounds frequently
Minimal force constantly when moving objects
Requires close mental and visual attention when working with computers, telephones and documentation systems.
Job Type: Full-time
Pay: From $22.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Experience:
- medical insurance: 3 years (Required)
Work Location: In person
