Managed Vision Care - Billing Operations Associate Job Northern Kentucky USA,Healthcare

Summary

The purpose of this position is to ensure accurate, compliant, timely billing and appropriate reimbursement for all professional vision or medical exams and vision material services from all vision insurance payers. This may include accurate and timely identification and completion of point of sale customer account, billing, payment posting, contractual write-offs, adjustments, follow-up, and collection of unpaid accounts, per state and federal insurance regulations for members receiving services at Visionworks retail stores.

Pay Class and Pay

Pay Class: Full Time and Remote

Pay Rate: $14.54 - $18.18

Essential Responsibilities

Prepare and submit clean claims to various insurance companies either electronically or by paper in accordance with specific payer guidelines and/or contract requirements

Analyze and correct first pass rejected claims for completeness and accuracy of information for second pass clean claim submission

Research and perform all primary and secondary billing claim status follow up activities for assigned insurance plans

Review, evaluate and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation required

Research and recommend any third party customer account adjustments and/or write-offs to Manager based upon collectability of account

Support and assist store associates with ensuring all proper customer demographic and authorizations are present for clean claim submittal to insurance carriers for accurate claims processing and payment

Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner

Generate and submit monthly patient balance due statements to customers as dictated by the explanation of benefits received from their insurance carrier

Education

High School Diploma, GED, or equivalent work experience

Experience & Background

Zero to one (1) years of experience in medical insurance claims billing preferred
Proficient in MS Excel and Word.
10-Key by touch.

Language Skills

Well-developed verbal, listening and phone communication skills
Good written communication skills with the ability to write routine correspondence

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

Reasoning Ability

Ability to define problems, collect data, establish facts, and identify trends.
Ability to exercise good judgment and elevate issues appropriately

Essential Responsibilities related to Physical Demands/Work Environment

The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the associate is required to stand, use hands and fingers to handle, feel, pick or pinch, and talk or hear most of the time.

The associate is occasionally required to stand, walk, and reach with hands and arms. The associate must frequently lift and/or move up to 20 pounds. The noise level in this location is moderate (use of computers, printers and machines).

Stand: x
Walk: x
Sit: x
Use hands to finger, handle, or feel: x
Reach with Hands and Arms: x
Climb or balance: x
Stoop, kneel, crouch, or crawl: x
Talk or hear: x
Close Vision (clear vision at 20 or less): x

Essential Responsibilities related to Behavioral Characteristics

Strong organizational skills and ability to execute manual detailed tasks.
Strong customer service focus and commitment.
Ability to establish and maintain effective working relationships within the team.
Ab…