Billing and Accounts Receivables Specialist

Southern Vitreoretinal•Tallahassee, FL

3d•$16 - $19•Onsite

About The Position

Southern Vitreoretinal Associates (SVA) is seeking a Billing and Accounts Receivables Specialist to join their team in Tallahassee, FL. SVA is an Ophthalmology practice specializing in retina care with six offices and six physicians. The ideal candidate will thrive in a fast-paced environment, exhibit exceptional attention to detail, and demonstrate the ability to manage multiple priorities with urgency and accuracy. Under the general supervision of the Assistant Business Office Manager, the Billing and Accounts Receivables Specialist will be responsible for obtaining prior authorizations, working outstanding insurance balances for services rendered by SVA, and ensuring timely reimbursement. The role involves researching and analyzing all open claims and unpaid insurance balances, resolving outstanding issues promptly, and assisting with authorizations, payments, and patient communications as needed.

Requirements

High School diploma or equivalent.
1 year minimum of Billing experience required.
6 months minimum of Accounts Receivable Experience required.
Strong understanding of private insurance rules and regulations.
Excellent organizational skills and keen attention to detail.
Computer literacy with medical accounts receivable programs and internet-based websites.
Able to follow directions quickly and efficiently with varying workloads and interruptions.
Must be able to work well under pressure and deal with coworkers in a courteous and cooperative manner.
Good communication skills.
Excellent customer service.
Must be willing to work on-site, in-office, NO REMOTE WORK will be available.

Nice To Haves

Proficiency in reviewing and interpreting Explanation of Benefits (EOBs) is a plus.
Knowledge of medical billing processes and terminology is a plus.
Excel skills, including formulas, pivot tables, and data analysis is a plus.

Responsibilities

Obtain authorizations for office visits and physician-administered medications.
Perform extensive A/R work, including handling claim denials, submitting appeals, checking claim statuses, confirming payments match fee schedules, and contacting insurance companies.
Post payments to the accounts receivable system from all insurance carriers, patients, and funding companies.
Obtain insurance eligibility and benefits information with all major insurance companies.
Explain patient benefits to patients in a clear and professional manner.
Calculate patient amount due and contact patients via telephone.
Review schedules prior to the date of service.
Approve scheduled and same-day injections after checking for necessary authorizations and communicate such to clinical staff.
Maintain excellent communication and interpersonal skills with physicians, patients, and co-workers.
Work with Patient Assistance Programs to enroll patients and explain these programs to patients.
Utilize ICD-10 / CPT Code knowledge.
Read and interpret explanation of benefits.
Post payments to the accounts receivable system.
Review next-day balances.
Facilitate the rapid and successful conversion of patient revenue into cash, minimize debt, improve cash flow, and manage the overall health of the Clinic’s receivables.
Meet or exceed Key Performance Indicators (KPIs) relevant to the work assigned to achieve best practice measures for Revenue Cycle.