Ophthalmic Coding Specialist

Retina Consultants of Houston•Houston, TX

23d•Onsite

About The Position

Retina Consultants of Texas (RCTX) is seeking an Ophthalmic Coding Specialist to review medical records and assign accurate diagnosis and procedure codes to patient health information. The role uses coding classification schemes including ICD-10-CM (which may include PCS) and HCPCS/CPT, and requires coding diagnoses, conditions, and procedures documented by physicians. The position reports to the Spurs Lane office in San Antonio. The specialist supports accurate coding and billing, performs internal chart audits, and works with cross-functional teams to address patient billing questions and insurance inquiries. The role also monitors aging accounts and may handle business office phone calls. The employee is expected to represent the practice professionally and treat internal and external patients courteously. RCTX is a retina-only ophthalmology practice that emphasizes Hard Work, Authentic Care, and Innovation. Full-time eligible employees receive the listed competitive benefits after a 60-day introductory period, except where a benefit is specified as starting on the date of hire. The position pays $22.00 or more per hour and is eligible for overtime.

Requirements

High school diploma or GED equivalent.
At least two years of experience in a medical office; ophthalmology office experience is preferred.
Experience in medical billing and knowledge of CPT/ICD-10 coding required.
Basic understanding of algebraic principles.
Knowledge of minor and major surgical procedures, including intravitreal injections and retina surgeries.
Understanding of Medicare and other common insurance requirements for quality reporting and payer compliance.
Knowledge of required examination components for appropriate ICD-10 selection and CPT coding.
Training and understanding of HIPAA requirements and patient confidentiality.
Ability to learn Nextgen/Nextech quickly and efficiently.
Strong, professional interpersonal skills.
Understanding of medical terminology and/or ophthalmic terminology.
Ability to maintain a calm, positive attitude and professional demeanor in stressful situations.
Ability to respond to changing workloads and work environments.
Excellent verbal and written communication skills.
Ability to manage multiple projects simultaneously.
Strong computer skills, accurate data entry, and attention to detail.
Must maintain patient confidentiality in accordance with clinic policy and HIPAA guidelines.
Ability to multitask and work in a fast-paced environment.
Ability to sit for long periods of time.
Manual dexterity sufficient to operate a keyboard, calculator, telephone, and other office equipment.

Nice To Haves

College degree preferred.
Scribe certification preferred.
Ophthalmic coding experience preferred.

Responsibilities

Assign diagnosis and procedure codes using ICD and CPT coding systems.
Ensure codes are accurate and correctly sequenced according to government and insurance requirements.
Document chart errors accurately according to practice protocols.
Code minor and major surgical procedures, including intravitreal injections and retina surgeries.
Assist with initiating billing and rebilling for procedures using appropriate CPT and ICD coding.
Conduct internal chart audits.
Work with cross-functional teams to resolve patient billing questions and inquiries.
Respond promptly to insurance company inquiries in company systems.
Monitor the aging accounts report and take action on delinquent items.
Handle business office phone calls as needed.
Represent the practice professionally and treat internal and external patients courteously.
Perform other tasks as required.

Benefits

Medical, dental, and vision benefits (employee-paid).
Short-term disability (employee-paid).
Voluntary life insurance (employee-paid).
Accident, critical illness, and hospital indemnity coverage (employee-paid).
Pet insurance (employee-paid).
Pre-tax HSA contributions, including employer contributions.
401(k) retirement savings plan with Roth and Traditional options; employer 3% safe harbor contribution.
Long-term disability (employer-paid).
$25,000 basic life insurance policy (employer-paid).
Annual performance merit increases.
Certification opportunities.
Rewards and recognition platform.
WellHub Starter Plan gym membership.
Paid time off.
Eight paid holidays and one floating holiday annually.
Overtime eligibility.