Managed Vision Care - Billing Operations Assoc, Billing Operations

Visionworks • San Antonio, TX

53d • Hybrid

About The Position

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.

Requirements

• High School Diploma, GED, or equivalent work experience
• Zero to one (1) years of experience in medical insurance claims billing preferred
• Proficient in MS Excel and Word.
• 10-Key by touch.
• Well-developed verbal, listening and phone communication skills
• Good written communication skills with the ability to write routine correspondence
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Ability to define problems, collect data, establish facts, and identify trends.
• Ability to exercise good judgment and escalate issues appropriately
• 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.
• Ability to work well with diverse personalities.
• Tactful, mature and flexible.
• Ability to work onsite and participate in interactive onsite meetings on a regular and predictable basis.
• Ability to initiate immediate interaction, coordination and collaboration with team members, clients, customers etc.
• All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees