Ophthalmology Claims Processor & Clinical Support Specialist

Ophthalmology Claims Processor & Clinical Support Specialist 3.6 3.6 out of 5 stars Anniston, AL 36207 $15

• $18 an hour
• Full-time East Alabama Eye Clinic 5 reviews $15
• $18 an hour
• Full-time Join Our Team at East Alabama Eye Clinic!

At East Alabama Eye Clinic , we are committed to delivering exceptional Eye Care and outstanding service to our Patients. We're seeking a dynamic, versatile individual to join our team.

Job Title:

Ophthalmology Claims Processor & Clinical Support Specialist Location(s): Principally Based in

Anniston AL Job Type:

Full-Time Schedule:

Monday

• Friday, 7:30 AM
• 4:30 PM (Hours may vary slightly depending on clinic needs and location)

Pay:

Competitive, Based on experience

Role Overview:

We are seeking a versatile Ophthalmology / Eye Care Claims Processor & Clinic Support Specialist to join our practice. This unique dual-function role primarily manages our specialized ophthalmic revenue cycle while occasionally cross-training to provide vital hands-on assistance to our doctors in the clinic when needed. Key Primary Components (Revenue Cycle Management):

Process Claims:

Code and submit clean electronic and paper claims specifically tailored to eye care guidelines.

Process Third-Party Payments:

Post and reconcile insurance payments, manage Electronic Remittance Advices (ERAs), and ensure exact balance sheet accuracy.

Work Collections:

Manage outstanding accounts receivable (A/R) aging reports, contact patients / payors regarding past-due balances, and arrange compliant payment.

Insurance Pre-Certification:

Secure mandatory prior authorizations for specialized ophthalmology procedures, surgical injections, and advanced diagnostic imaging before care is delivered.

Investigate & Re-process Rejected Claims:

Promptly analyze, fix, and resubmit denied, rejected, or underpaid claims through targeted appeals. Assist with

Periodic Payor Audits:

Compile, organize, and securely deliver required medical documentation to insurance companies during periodic payor audits. Key Supplementary Components (Clinical Support):

Periodic Clinic Support:

Cross-train to fill in seamlessly for clinical staff during high-volume periods or staff absences. Assist the

Doctor:

Directly assist the ophthalmologist or other eye care specialist with basic patient workups, documenting exam notes, and prepping exam rooms.

Ideal Qualifications & Skills:

Experience:

1-3 years of experience in medical billing, with a strong preference for Ophthalmology or Optometry billing .

Clinical Adaptability:

Willingness to train in basic clinical tech and optician skills; prior experience as an ophthalmic or eye care technician is a major plus.

Specialized Knowledge:

Familiarity with vision plans (e.g., VSP, EyeMed) versus major medical insurance guidelines, alongside standard CPT and ICD-10 coding.

Technical Skills:

Proficiency with practice management software and electronic health records (EHR).

Benefits We Offer:

Competitive pay Health insurance Dental Insurance 401(k) with 401(k) matching Employee discounts on eyewear and services Paid time off Join a team where your skills and dedication make a difference in the lives of our Patients. Be part of a supportive, professional environment that fosters growth and success. to start your rewarding career with East Alabama Eye Clinic!

Pay:

$15.00

• $18.

00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Employee discount Health insurance Paid time off Retirement plan

Work Location:

In person