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
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