Back to jobs New Claims Readiness and Billing Specialist II Ballwin,MO Apply EyeCare Partners is the nation's leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com .

Job Title:

Claim Readiness and Billing Specialist

II SUMMARY

The Claim Readiness & Billing Specialist is responsible for resolving all assigned claim edits & claims submissions to third-party payers in a timely and efficient manner. These edits will be resolved and submitted within the clearinghouse or the practice management system in a manner determined by the Insurance Billing Supervisor. They will also ensure prior day edits are accurately resolved and prepared for billing, identify and propose new claim edits and changes to current protocols, and identify root cause issues that are then communicated to RCM leaders and dealt with based upon RCM impact. The Level II Claim Readiness and Billing Specialist also performs charge entry and requires coding knowledge.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Charge review & posting of fee tickets as applicable.
• Resolve claim edits daily while noting account actions for a complete audit trail of billing activity.
• Ensure all prior day's edits have been accurately resolved, and the claim is ready to bill.
• Submission of assigned claims to third-party payers, where applicable.
• Process clearinghouse rejections daily for assigned payers.
• Maintain applicable system and website logins and review payer correspondence or bulletins for protocol or regulatory changes.
• Maintain a complete understanding of bill editing and submission protocols within required software systems.
• Identify opportunities for new claim edits and provide recommendations to management for the implementation of identified edits.
• Identify root cause issues causing claim edits and communicate these issues to RCM leadership for upstream education via an understanding of how billing edits impact overall AR.
• Adhere to ECP confidentiality policy which includes verbal, written, computer-generated, computer accessed, filmed, and recorded information related to patients, their family and visitors, staff, physicians, clients, and is responsible for the protection of the confidentiality of data at all times.
• Work safely and follow all ECP safety requirements, reporting all incidents, near misses, and adverse events.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization.

EDUCATION AND/OR EXPERIENCE

Minimum Required:

HS or G.E.D.

Minimum Required:

2 years of billing, follow-up, or related experience

• Experience in Optometry/Ophthalmology physician practice environment.
• Experience in the use of CPT and HCPCS Knowledge, Skills and Abilities Requirements
• Possess strong working knowledge of CPT coding and ICD10 coding as it relates to ophthalmology medical services.
• Understand the utilization of modifiers and other coding rules to include the AMA and other coding organizations.
• Knowledge of medical terminology and consistent application of medical documentation requirements.
• Ability to follow policies and procedures for compliance, medical billing, and coding
• Ability to type and enter data with proficiency and accuracy.
• Knowledge of medical terminology, healthcare coding systems, and clinics functions.
• Ability to operate essential office equipment, including multi-line phone, computer, fax machine, scanner, and photocopy machine.
• Professional in appearance and actions
• Logical and Critical thinking skills to problem solve
• Customer-focused with excellent written, listening and verbal communication skills
• Enjoys learning new technologies and systems
• Detail oriented, professional attitude, reliable, prioritizing tasks and goals
• Exhibits a positive attitude and is flexible in accepting work assignments and priorities
• Meets attendance and tardiness expectations
• Management and organizational skills to support the leadership of this function
• Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
• Interpersonal skills to support customer service, functional, and teammate support need  Able to communicate effectively in English, both verbally and in writing
• Ability for basic to intermediate problem solving, including mathematics
• Intermediate to Advanced computer operation  Proficiency with Microsoft Excel, Word, PowerPoint and Outlook
• Travel to other site locations may be necessary. Thus, those needing to travel for work must have access to dependable transportation, and driving record must meet company liability carrier standards
• Specialty knowledge of systems relating to job function
• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

Location/Work Environment:

For remote team members, HIPAA compliant home office environment. Ability to work in a remote environment while performing required duties and remaining patient focused. Able to work varying shifts including early mornings/evenings to attend meetings and cross training or support other initiatives.

Exposure:

Works in a normal office environment during normal business hours. May be exposed to blood or bodily fluids. May also be exposed to various cleaning supplies.

Equipment:

The equipment typically used in this position is a computer, fax, copier, printer, scanner and telephone. Must have good working knowledge of Microsoft applications. Other equipment may be used as needed. Personal Protective Equipment (PPE) follows standard precautions using personal protective equipment.

Physical Requirements:

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. If you need assistance with this application, please contact (636) 227-2600 EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Please do not contact the office directly - only resumes submitted through this website will be considered.

NOTE:

Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time Apply for this job

• indicates a required field First Name
• Last Name
• Email
• Phone Country
• Phone
• 244 results found No results found Afghanistan +93 Åland Islands +358 Albania +355 Algeria +213 American Samoa +1 Andorra +376 Angola +244 Anguilla +1 Antigua & Barbuda +1 Argentina +54 Armenia +374 Aruba +297 Ascension Island +247 Australia +61 Austria +43 Azerbaijan +994 Bahamas +1 Bahrain +973 Bangladesh +880 Barbados +1 Belarus +375 Belgium +32 Belize +501 Benin +229 Bermuda +1 Bhutan +975 Bolivia +591 Bosnia & Herzegovina +387 Botswana +267 Brazil +55 British Indian Ocean Territory +246 British Virgin Islands +1 Brunei +673 Bulgaria +359 Burkina Faso +226 Burundi +257 Cambodia +855 Cameroon +237 Canada +1 Cape Verde +238 Caribbean Netherlands +599 Cayman Islands +1 Central African Republic +236 Chad +235 Chile +56 China +86 Christmas Island +61 Cocos (Keeling) Islands +61 Colombia +57 Comoros +269 Congo - Brazzaville +242 Congo - Kinshasa +243 Cook Islands +682 Costa Rica +506 Côte d'Ivoire +225 Croatia +385 Cuba +53 Curaçao +599 Cyprus +357 Czechia +420 Denmark +45 Djibouti +253 Dominica +1 Dominican Republic +1 Ecuador +593 Egypt +20 El Salvador +503 Equatorial Guinea +240 Eritrea +291 Estonia +372 Eswatini +268 Ethiopia +251 Falkland Islands +500 Faroe Islands +298 Fiji +679 Finland +358 France +33 French Guiana +594 French Polynesia +689 Gabon +241 Gambia +220 Georgia +995 Germany +49 Ghana +233 Gibraltar +350 Greece +30 Greenland +299 Grenada +1 Guadeloupe +590 Guam +1 Guatemala +502 Guernsey +44 Guinea +224 Guinea-Bissau +245 Guyana +592 Haiti +509 Honduras +504 Hong Kong SAR China +852 Hungary +36 Iceland +354 India +91 Indonesia +62 Iran +98 Iraq +964 Ireland +353 Isle of Man +44 Israel +972 Italy +39 Jamaica +1 Japan +81 Jersey +44 Jordan +962 Kazakhstan +7 Kenya +254 Kiribati +686 Kosovo +383 Kuwait +965 Kyrgyzstan +996 Laos +856 Latvia +371 Lebanon +961 Lesotho +266 Liberia +231 Libya +218 Liechtenstein +423 Lithuania +370 Luxembourg +352 Macao SAR China +853 Madagascar +261 Malawi +265 Malaysia +60 Maldives +960 Mali +223 Malta +356 Marshall Islands +692 Martinique +596 Mauritania +222 Mauritius +230 Mayotte +262 Mexico +52 Micronesia +691 Moldova +373 Monaco +377 Mongolia +976 Montenegro +382 Montserrat +1 Morocco +212 Mozambique +258 Myanmar (Burma) +95 Namibia +264 Nauru +674 Nepal +977 Netherlands +31 New Caledonia +687 New Zealand +64 Nicaragua +505 Niger +227 Nigeria +234 Niue +683 Norfolk Island +672 North Korea +850 North Macedonia +389 Northern Mariana Islands +1 Norway +47 Oman +968 Pakistan +92 Palau +680 Palestinian Territories +970 Panama +507 Papua New Guinea +675 Paraguay +595 Peru +51 Philippines +63 Poland +48 Portugal +351 Puerto Rico +1 Qatar +974 Réunion +262 Romania +40 Russia +7 Rwanda +250 Samoa +685 San Marino +378 São Tomé & Príncipe +239 Saudi Arabia +966 Senegal +221 Serbia +381 Seychelles +248 Sierra Leone +232 Singapore +65 Sint Maarten +1 Slovakia +421 Slovenia +386 Solomon Islands +677 Somalia +252 South Africa +27 South Korea +82 South Sudan +211 Spain +34 Sri Lanka +94 St.

Barthélemy +590 St. Helena +290 St. Kitts & Nevis +1 St. Lucia +1 St. Martin +590 St. Pierre & Miquelon +508 St. Vincent & Grenadines +1 Sudan +249 Suriname +597 Svalbard & Jan Mayen +47 Sweden +46 Switzerland +41 Syria +963 Taiwan +886 Tajikistan +992 Tanzania +255 Thailand +66 Timor-Leste +670 Togo +228 Tokelau +690 Tonga +676 Trinidad & Tobago +1 Tunisia +216 Turkey +90 Turkmenistan +993 Turks & Caicos Islands +1 Tuvalu +688 U.S. Virgin Islands +1 Uganda +256 Ukraine +380 United Arab Emirates +971 United Kingdom +44 United States +1 Uruguay +598 Uzbekistan +998 Vanuatu +678 Vatican City +39 Venezuela +58 Vietnam +84 Wallis & Futuna +681 Western Sahara +212 Yemen +967 Zambia +260 Zimbabwe +263 Resume/CV

• Attach Attach Dropbox Enter manually Enter manually Accepted file types: pdf, doc, docx, txt, rtf Cover Letter Attach Attach Dropbox Enter manually Enter manually Accepted file types: pdf, doc, docx, txt, rtf Education School Select.

.. Degree Select... Discipline Select... Start date month Select... Start date year End date month Select... End date year Add another Are you eligible to work in the U.S.?

• Select... Are you at least 18 years or older? (If no, you may be required to provide work authorization to work.)
• Select... Have you ever been terminated from employment or asked to resign by an employer?
• Select... If yes, please provide company name and details.
• Can you work any shift?
• Select... Can you work overtime, including weekends?
• Select... Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?
• Select... Were you referred by a current employee?
• Select... If referred by a current employee, what is their full name?
• To the best of your knowledge, have you ever worked for our company or affiliated companies?
• Select.

.. EyeCare Partners and it's affiliated companies are an equal opportunity employer. EyeCare Partners does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service. I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for EyeCare Partners to hire me. If I am hired, I understand that either EyeCare Partners or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of EyeCare Partners has the authority to make any assurance to the contrary. I attest with my typed signature below that I have given to EyeCare Partners true and complete information on this application. No requested information has been concealed. I authorize EyeCare Partners to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Signature:

• I attest that I am not an "Ineligible Person" and that I understand that I must immediately disclose to EyeCare Partners any debarment, exclusion, or suspension.

Ineligible Persons includes an individual or entity who is currently excluded, debarred, suspended, or otherwise ineligible to participate in the Federal health care programs or in Federal procurement or non procurement programs; or has been convicted of a criminal offense that falls within the ambit of 42 U.S.C. § 1320a‐7(a), but has not yet been excluded, debarred, or suspended.

Signature:

• What is your desired compensation for this role?
• Have you obtained a High School Diploma or GED?
• Select... If you accept employment with our company, will you live or work in the state of IL?
• Select... Do you currently hold any of these certifications/licenses? Please check all that apply. If not, please select NONE.
• None National Contact Lens Examiners (NCLE) American Board of Opticianry (ABO) Licensed Dispensing Optician (LDO) Certified Ophthalmic Assistant (COA) Certified Ophthalmic Technician (COT) Certified Surgical Technologist (CST) Ophthalmic Scribe Certification (OSC) Certified Paraoptometric (CPO) Certified Occupational Therapy Assistant (COTA) Voluntary Self-Identification For government reporting purposes, we ask candidates to respond to the below self-identification survey.

Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file. As set forth in Eye Care Partners Career Opportunities's Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law. Gender Select... Are you Hispanic/Latino? Select... Race & Ethnicity Definitions If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows: A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability. A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. Veteran Status Select... Voluntary Self-Identification of Disability Form CC-305 Page 1 of 1 OMB Control Number 1250-0005 Expires 07/31/2029 Why are you being asked to complete this form? We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp . How do you know if you have a disability? A disability is a condition that substantially limits one or more of your "major life activities." If you have or have ever had such a condition, you are a person with a disability.