Description

This individual plays a crucial role in the financial operations of the ophthalmic office. This individual is responsible for the timely and accurate processing of incoming payments, manages billing discrepancies, and maintains a comprehensive record of all accounts receivable activities, reviews problem accounts, and identifies necessary action to be taken.  Working knowledge of Athena Health is a plus.

Requirements

Full Cycle Revenue Management

       Is responsible for the entire collection processes of all patients.

       Prepare and submit billing data and medical claims to insurance companies

       Processes insurance claims and payments for eye care services and products.

       Verifies patient information and eligibility for coverage.

       Codes diagnoses and procedures according to standard guidelines.

       Resolves billing issues and discrepancies with patients and insurance companies.

       Processes and mails patient statements weekly.

       Calls on insurance/patient accounts that are 60 days past due.

       Establishes possible payment plans if approved by the practice administrator.

       Works with the front desk team to ensure same-day collections for co-pays, refraction fees, and outstanding patient balances.

       Monitors and help office manager respond to insurance letters for incorrect payments or chart audits.

       Meets with the office manager weekly to review and discuss accounts receivable balances exceeding 90 days.

       Reviews the accounts Aging Analysis Report monthly to determine the accounts requiring immediate attention (60 days and over $500 balance are priority). 

       Reconciles all cash transactions daily.

       Balances day sheets and delivers to the Practice Administrator.

       Formulates bank deposits on an as-needed basis.

       Reconciles credit card balance daily.

       Remedies any previously approved insurance claim that has subsequently been denied.

       Handles all patient complaints regarding billing promptly and consistently.

       Coordinates all patient and insurance refunds with the Practice Administrator.

       Coordinates the electronic processes of charges, superbills, insurance forms, and patient statements.