Medical Biller
$37,440–$47,840 year
On-site · Carson City, Nevada, United States
Job Summary
Ophthalmology medical billing specialist responsible for accurately posting clinic and hospital charges with a primary focus on ophthalmology E/M coding, reviewing documentation for CPT/ICD-10 accuracy, drafting appeals for denied claims, and assisting patients with account questions. Responsibilities include A/R follow-up, denial management, communication with providers, drafting appeal letters for ophthalmic services and diagnostic testing, electronic claims submission, accurate payment posting, HIPAA compliance, ongoing education on ophthalmology coding updates, and supporting team workflows in a patient-care setting.
Required Qualifications
- Minimum of a high school diploma or equivalent
- 2-5 years of medical billing experience, with preference for ophthalmology or surgical specialties
- Proficiency in CPT, ICD-10, and modifiers, specifically regarding global surgery policies
- Familiarity with surgical billing, global periods, and Medicare/Medicaid/Medi-Cal rules
- Vast knowledge of Medical terminology
- Strong interpersonal skills
- Experience with EMR/billing systems such as Practice +, MoD MED, TriZetto, and Availity
- Excellent organizational skills and a high level of accuracy
- Strong attention to detail, analytical skills, and communication capabilities for handling patient and payer inquiries
- Ability to read and create reports, checklists, and correspondence, and to understand complex written instructions
- Excel knowledge a plus
- Strong analytical skills with the ability to perform calculations and review detailed coding data quickly and accurately
- Ability to apply common sense and sound judgment to resolve routine problems based on standardized procedures
- Must be a self-motivated multi-tasker
- Bi-Lingual is a plus
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