Billing Specialist

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Dartmouth, MA, US

2 days ago Requisition

Salary Range: $19.00 To $22.00 Hourly

Claris Vision was formed in 2011, bringing together some of New England's top eye care practices to provide the most comprehensive spectrum of vision care services available in the region. Claris Vision's team of leading physicians are dedicated to providing the best clinical care, utilizing leading technology, and ensuring an individualized experience and high-quality care plan for each patient.

Our Billing Specialist is responsible for billing paper and electronic claims for primary and secondary payers. Completes timely and accurate billing for designated payer class ensuring all claims are submitted on the same day of receipt. Monitors outstanding accounts and applies late charges. Receives and answers billing-related inquiries and prepares daily billing activity and balancing reports.

• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers, Medicare, and Medicaid.
• Receive payment denials, investigate, and rectify the situation with either the payer or patient to include claim reconsiderations and appeals and consulting with patient and/or his or her family as needed.
• Review assigned aging reports.
• Work with office team leads to obtain insurance referrals, pre-authorizations, and verification as it relates to denied claims.
• Initiate private pay collections after insurance cancellation, denials, or other issue.
• Work with patients to develop self-pay arrangements and payment plans.
• Assist patients and their families with applying for Care Credit and other financial solutions.
• Posting insurance and patient payments to open invoices in a timely manner
• Processing electronic remits, credit card payments, and other payments
• Following up on outstanding claims
• Reconciling payments and posting them to patient accounts with the correct amount and adjustment.
• Answers questions from patients, staff, and insurance companies.
• Document payment records and issues as they occur.
• Works closely with the billing director, center managers, team leaders, and corporate medical director to ensure all processes are streamlined to minimize disruption in patient care while maximizing reimbursement.
• Other duties and responsibilities may apply as the position evolves.
• Ensure medical data is secure, accessible, and accurate for billing and reimbursement for all services.
• Maintaining a comprehensive knowledge of contemporary health record and coding practices.
• Keep current on payer requirements via research and coaching to ensure guidelines and procedures are being met for each payer.
• Maintains strictest confidentially; adheres to all HIPAA guidelines/ regulations.
• Must have a clear understanding of company policies, including the company manual, and department policies.

• Exceptional Customer Experience – Understands and anticipates customer needs, takes action to meet customer's needs. Strives to exceed customer expectations.
• Proactive
  - Keep others informed. Ask for help when needed, brings service challenges to supervisor.
• Drive for Results – Strives for improving the delivery of services with a commitment to continuous improvement.
• Focus on Efficiency – Utilizes technology, innovation, and process improvements to continuously improve efficiency and effectiveness.
• Teamwork
  - Participates as a team member and establishes strong working relationships with teammates and across the organization.
• Celebrates Change
  - Receptive to new ideas and responds to changes with…