Billing Specialist - (Benefits/Insurance)

Job Summary

If you want to know about the requirements for this role, read on for all the relevant information.

The billing process involves applying information from the patient's eyeglasses prescription and determining the correct codes and charges for each item and service provided as well payment reconciliation resulting in efficient accounts receivable management.

Essential Functions

• Review charges in the patient's account and correctly enter claims into the insurance carrier's billing system.
• Post payments received by insurance carrier at the line-item level.
• Review payments for collection accuracy and re-bill as needed.
• Differentiates between a refractive and a medical diagnosis and applies the diagnosis to the service rendered.
• Utilize multiple software programs and reference sheets to effectively process claims for eyeglasses, contact lenses, and routine vision services.
• Complete tasks as assigned and meet production goals for the number of claims processed in a specified time.
• Maintain a list of claims that are unable to be filed.
• Recognize different insurance plans and follow coding directives.
• Read optical prescriptions and assign appropriate codes (with training / guides).
• Recognize demographic errors in patient's chart and correct them (e.g., misspelled name).
• Refer to plan pages from insurance to apply appropriate modifiers to codes.

Requirements

• High School Diploma.
• 1 year of office experience.
• Some previous medical and billing experience preferred.
• Familiarity with CPT, HCPC, and ICD9.
• Willingness to learn coding for optical products.
• Efficient and accurate entry of claims into specified insurance portals.
• Working knowledge of Excel, PDF, and other common desktop programs.
• Ability to navigate multiple internet portals simultaneously on different screens.
• Problem-solving skills and ability to work independently.

Nesco Resource offers a comprehensive benefits package for our associates, which includes a MEC (Minimum Essential Coverage) plan that encompasses Medical, Vision, Dental, 401K, and EAP (Employee Assistance Program) services.

Nesco Resource provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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