Job description

Ophthalmology or Optometry AR specialist

Evenflow Solutions has a client in the that is looking to add an Ophthalmology or Optometry AR specialists to their team

• Contract to Hire or Direct Hire positions
• This will be a 100% Remote position
• Must have at least 5 years of experience in Optometry or Ophthalmology
• Must have Nextgen or Compulink Experience

Overview of Position

A/R Specialist is responsible for calling all insurance companies and utilizing online resources to check claim status, resubmit claims as necessary via paper or electronically, file appeals, track denial trending, resolve denials, and ensure maximum revenue capture. In addition, this role will facilitate the timely receipt of payments and ensure balances on accounts are correct and appropriately prorated.

Job Duties and Expected Performances:

• Identify the root cause of insurance denials, send appeals to payors, and take appropriate actions to assure prompt payment.
• Review encounters via Practice Management System, reports, and other sources with an average productivity of 50 accounts per day.
• Document follow-up appropriately in the practice management system.
• Register with all necessary payor portals and submit all the required verification documents for access.
• Maintain an acceptable error rate and productivity level within department policy.
• Perform collection actions, including third-party appeals and resubmitting claims to third party payers.
• Identify and bill secondary or tertiary insurances.
• Reconcile carrier submissions, edits, and rejection reports.
• Resolve incoming patient calls with excellent customer service skills.
• Employ tactfulness in dealing with insurance companies/patients regarding accounts in verbal and written communication, while being professional and courteous at all times.
• Identify, verify, and document adjustments according to established policies and procedures.
• Research and prepare credits for refund approval.

Required:

• High School Graduate or General Education Degree (GED)
• At least 5 years of experience in Optometry and Ophthalmology third-party billing guidelines and expertise.

Experience:

• Must have Experience with Nextgen PM/HER or Compulink
• At least Five years of professional medical billing and collecting experience, or certification obtained from a nationally accredited billing program, i.e., CMBS (Certified Medical Billing Specialist).
• Must have experience with Appeals and Denials process
• One year of patient collection experience
• Experience with Excel and Windows-based programs.
• Experience in performing tasks that require a basic understanding of accounting and math skills.

Preferred Experience

• COPC or OCS Certification (Certified Ophthalmology Coder or Ophthalmology Coding Specialist)
• One year of cash posting experience in Optometry and Ophthalmology.

Evenflow Solutions (ES) is an Equal Opportunity Employer. ES provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.

Job Types: Full-time, Contract

Pay: $22.00 - $24.00 per hour

Benefits:

• Health insurance

Schedule:

• Monday to Friday

Experience:

• Ophthalmology Billing: 5 years (Required)
• NextGen or Compulink: 3 years (Preferred)

Work Location: Remote

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