Billing Representative Optical

Advocate Health and Hospitals Corporation • Park Ridge, WI

9d • $22 - $33 • Onsite

About The Position

Determines who the financial responsible party is for eyewear and eye care and processes the billing appropriately. Reviews more complex accounts for any internal or external problems that may cause a delay in payment. Analyzes available information and decides course of action. Assists teams with more complex problem accounts as needed. Contacts insurance companies or any other person, organization or department whose assistance is needed to obtain payment of vision claim, until it is paid or rejected. Responds to telephone or written inquiries from insurance companies, employers, state agencies and patients regarding insurance claims. Process rejections by billing the patient; or resolving problems, and having the claim resubmitted for payment. Applies contractual allowances where necessary. Enters insurance information and charges for optical products and services, bills third party plans, receives payments and processes them. Reviews billing work queues to determine who should be billed for eye care services and processes the charges to the appropriate party. Trains optical staff in the proper methods of processing third party claims, process the "work queue", and entering third party orders in the optical software. Applies third party payments to individual accounts for Aurora optical shops, determines the patients responsibility and sends statements. Acts as a liaison and resource between the optical dispensaries, internal departments, and external third party groups to centralize the communication, reduce the duplication of correspondences, ensure accuracy, and eliminate distractions from the optical staffs primary patient care responsibilities. Identifies and reports trends that impact the accounts receivable process. Assists in identifying and implementing process improvement plans. Processes end of the month reports for all optical locations with an emphasis on accounts receivable balances, both patient and third party. Assist in evaluating current and potential third party plans to determine if the organization should participate in the plan and determine the appropriate method to administer the plan. Assists patients with processing third party claims and/or concerns. Reviews the patients products and services provided and helps internal and external customers with interpretation and application decisions.

Requirements

• High School Graduate.
• Typically requires 3 years of experience in billing including experience in processing claims and accounts receivable.
• Must have a detailed understanding of third party plans.
• Basic computer skills including use of Microsoft Office products (Word and Excel) or similar products.
• Proficient knowledge base and understanding of departmental specific billing procedures and patient account systems.
• Demonstrated ability to function as a resources to staff on complex billing issues.
• Problem solving, conflict resolution, customer service, and good analytical skills are necessary.
• Excellent communication and organizational skills.
• Ability to manage multiple demands, tasks and projects at one time.
• Must be able to sit the majority of the workday.
• Occasionally lifts up to 10 lbs.
• Exposed to a normal office environment.
• May be exposed to weather and road conditions due to travel.
• Operates all equipment necessary to perform the job.

Responsibilities

• Determines who the financial responsible party is for eyewear and eye care and processes the billing appropriately.
• Reviews more complex accounts for any internal or external problems that may cause a delay in payment.
• Analyzes available information and decides course of action.
• Assists teams with more complex problem accounts as needed.
• Contacts insurance companies or any other person, organization or department whose assistance is needed to obtain payment of vision claim, until it is paid or rejected.
• Responds to telephone or written inquiries from insurance companies, employers, state agencies and patients regarding insurance claims.
• Process rejections by billing the patient; or resolving problems, and having the claim resubmitted for payment.
• Applies contractual allowances where necessary.
• Enters insurance information and charges for optical products and services, bills third party plans, receives payments and processes them.
• Reviews billing work queues to determine who should be billed for eye care services and processes the charges to the appropriate party.
• Trains optical staff in the proper methods of processing third party claims, process the "work queue", and entering third party orders in the optical software.
• Applies third party payments to individual accounts for Aurora optical shops, determines the patients responsibility and sends statements.
• Acts as a liaison and resource between the optical dispensaries, internal departments, and external third party groups to centralize the communication, reduce the duplication of correspondences, ensure accuracy, and eliminate distractions from the optical staffs primary patient care responsibilities.
• Identifies and reports trends that impact the accounts receivable process.
• Assists in identifying and implementing process improvement plans.
• Processes end of the month reports for all optical locations with an emphasis on accounts receivable balances, both patient and third party.
• Assist in evaluating current and potential third party plans to determine if the organization should participate in the plan and determine the appropriate method to administer the plan.
• Assists patients with processing third party claims and/or concerns.
• Reviews the patients products and services provided and helps internal and external customers with interpretation and application decisions.

Benefits

• Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
• Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
• Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program

What This Job Offers

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