Billing Representative

Ophthalmic Consultants of Boston, Inc•Plymouth, MA

12d•$20 - $24

About The Position

The Entry-Level Billing Representative supports healthcare billing and revenue cycle operations by helping resolve insurance denials, referral and eligibility issues, and patient account questions. The role communicates with insurance companies, provider offices, and patients to help ensure claims are processed accurately and accounts move toward resolution. It is suited to someone beginning a career in healthcare billing, with an opportunity to learn medical billing, payer systems, and revenue cycle management.

Requirements

High school diploma or equivalent.
Strong verbal and written communication skills.
Comfort speaking by phone with patients, insurance companies, and provider offices.
Basic computer skills and ability to learn new systems and technology.
Strong organizational skills and attention to detail.
Ability to follow established guidelines and recognize when to ask questions or escalate an issue.
Positive attitude and collaborative, team-oriented approach.
Customer service skills, including patience, professionalism, and empathy.
Problem-solving skills and ability to manage follow-ups and maintain accurate documentation.

Nice To Haves

0–2 years of experience in customer service, healthcare, administrative support, or a related environment.
Interest in learning medical billing, insurance requirements, and payer systems.
Curiosity and motivation to develop knowledge of healthcare billing and revenue cycle operations.

Responsibilities

Review insurance denials and help resolve issues involving missing or incomplete referrals.
Contact primary care physician offices to obtain and follow up on referral documentation.
Help patients understand what information may be needed from their primary care physician for insurance coverage.
Use payer websites and billing systems to verify referrals, eligibility, benefits, coverage dates, plan information, and patient cost-sharing requirements.
Research eligibility issues, including inactive coverage, incorrect member information, and coordination of benefits discrepancies.
Communicate with insurance payers and patients to help resolve coverage and account issues.
Document eligibility results, payer communications, patient conversations, and next steps accurately in the billing system.
Update insurance information and escalate unresolved issues to the appropriate team.
Contact patients about outstanding self-pay balances and explain charges clearly and respectfully.
Assist patients with payment arrangements when appropriate and in accordance with department guidelines.
Follow up on unresolved balances and payment arrangements.
Refer billing disputes and financial assistance requests to the appropriate team.
Identify recurring denial issues and share insights to help improve billing processes and prevent future errors.
Collaborate with teammates and other departments to move accounts toward resolution.