Client is a highly successful Ophthalmology Group with 4 locations located in the Buffalo, NY, area.
Responsibilities:
The timely preparation and filing of insurance claims (paper and electronic claims transmission), insurance aging reports, and prior approvals.
The timely review and follow up on all claims and collection of insurance claims and patient accounts.
Play an active role in the coding process for medical claims and provider credentialing.
Essential Skills and Abilities:
Billing Operations:
Strong knowledge of CPT and Diagnosis Coding
Credentialing Experience
Effective Leadership Skills
String knowledge of medical insurance, payments and deductibles
Computer literate with spreadsheet and MS Office.
Strong mathematical and financial management skills.
Working knowledge of standard accounting principles..
Ability to manage staff
Audits – Prepare responses to all insurance company requests and audits, including provider incentive programs. Conducts Periodic internal chart audits.
Personnel Management:
Perform annual performance evaluations on all departmental staff and meet with the Administrator to discuss employee performance.
Hold staff accountable for accuracy and appropriateness.
Train new departmental staff members.
Credentialing:
Oversee all credentialing for new doctors and/or any renewals with regards to both insurance and hospital requirements.
Create and update all physicians on Council for Affordable Quality Healthcare (CAQH) and Provider Enrollment Chain & Ownership System (PECOS) website.
Payer and Medical Organization Relations:
Maintains appropriate relationships with all insurance provider representatives.
Maintains communications with all necessary MLMIC representatives and Medical organizations regarding patient care and physician/patient relations.
Qualifications:
Associates’ Degree or higher desired.
High school diploma or equivalent required.
At least 5 years of previous medical office billing experience.
