Senior Medical Billing Specialist
About The Position
Be Part of a Team That’s Advancing Vision Care—and the People Behind It At Ophthalmic Consultants of Boston (OCB), we don’t just deliver exceptional eye care—we build careers. As a nationally recognized leader in ophthalmology, we are proud to foster a collaborative, growth-focused environment where expertise is valued and professional development is encouraged. We are seeking an experienced and driven Senior Medical Billing Representative to join our Revenue Cycle team. In this role, you will be a key contributor to the financial health of the organization, tackling complex billing challenges, supporting team development, and helping ensure a seamless experience for our patients and providers. This position is fulltime, onsite at our Plymouth, MA location.
Requirements
- Strong knowledge of medical terminology, ICD-10 diagnosis codes, and CPT-4 procedure codes
- Advanced understanding of coding modifiers and their appropriate use
- Several years of experience in medical billing or revenue cycle operations
- Proven expertise in A/R follow-up and denial management
- Deep understanding of insurance eligibility, benefits, and reimbursement processes
- Familiarity with payer medical necessity requirements and billing policies
- Excellent communication and customer service skills
- Strong analytical, organizational, and problem-solving abilities
- High attention to detail and accuracy
- Ability to manage multiple priorities effectively
- Proficiency with Microsoft Office (Word, Excel, Outlook)
- Solid understanding of HIPAA regulations
Nice To Haves
- College degree preferred
- CPC, COPC, or similar certification preferred
Responsibilities
- Resolving complex claim edits, rejections, and denials with accuracy and efficiency
- Leading advanced A/R follow-up efforts to ensure timely reimbursement
- Analyzing denial trends and implementing proactive solutions
- Writing detailed, effective appeal letters aligned with clinical documentation and payer policies
- Ensuring compliance with timely filing requirements and regulatory standards
- Reviewing and validating patient demographics, insurance details, charges, and coding
- Serving as a subject matter expert for billing processes, coding, and payer requirements
- Collaborating with insurance carriers, patients, physicians, and internal teams to resolve complex inquiries
- Supporting accurate eligibility verification, authorizations, and referral processes
- Reviewing medical records to ensure alignment with medical necessity guidelines
- Identifying workflow improvements to reduce denials and increase efficiency
- Assisting with onboarding, training, and mentoring of new team members
Benefits
- Medical & dental insurance (starts on the 1st day of employment!)
- 401(k) plan with Company match
- Company paid Life Insurance
- Company paid Long Term Disability
- Eye care discounts
- Generous Paid Time Off and Paid Holidays
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
