Job Description

Job Description

Job Description

Job Summary

As an Ophthalmology Billing Generalist, you will be accountable for the submission of clean claims, billing secondary claims, entering patient charges, and AR work, providing exceptional customer service, explaining charges, payments, and balances to patients as well as working out payment arrangements. Our billing team is led by a strong, experienced Billing Manager who provides great leadership and is committed to developing the right candidate. Seeking a career-focused individual open to collaborative learning and mentorship. Familiarity with Nextech is a plus. Proficient accurate, timely data entry is essential. Successful candidates will demonstrate dependability, reliability, trust, the ability to work both in a team setting as well as independently with minimal supervision.

General Accountabilities

• Provide real-time support to front desk staff by addressing patient inquiries as they arise.
• Strong command of ophthalmic terminology, diagnosis codes, and procedure codes. 
• Verification of insurance eligibility, benefits, referrals, and pre-authorizations.
• Determination of appropriate charges, co-pays, deductibles, and other out-of-pocket fees based on services provided.
• Contact patients to collect outstanding balances.
• Consistently submit clean claims with a high level of accuracy, achieving at least 99% accuracy rate 
• Transmit electronic claims via third-party clearinghouse and file paper CMS-1500 forms.
• Provide information to insurance carriers or patients regarding patient accounts.
• Post payments and review EOB from third party payers to determine if payment was made correctly and if denials can be re-billed.
• Identify problem accounts requiring further work.
• Generate, review, and upload patient statements to a third-party portal. 
• Assist patients with billing questions and notify supervisor of ongoing challenges.
• Maintain electronic files for charge slips, EOBs, and other billing documentation.
• Address department email, faxes, and voicemails daily.
• The ability to communicate with patients using understandable language to help them navigate through otherwise complex insurance terminology.
• Thorough and effective documentation through every step of the billing process. 
• Experience with Nextech is a plus.
• Performs other related duties as assigned or requested. 

Job Qualifications

• A clear understanding of ICD-10 and CPT codes is required.
• Experience: 2 years of ophthalmology billing experience in private healthcare
• Ability to read, write, speak and understand English fluently
• Bilingual (Spanish) preferred
• Education: High School or GED
• In office only. Not currently offering remote opportunities.

Join the dedicated team at DuPage Ophthalmology, where we prioritize superior patient care in a positive, healthy work environment. Explore more about our practice by visiting DuPage Ophthalmology is proud to be an equal-opportunity employer.

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