[Hiring] Medical Biller / Admin - Ophthalmology Practice @Staffing for Doctors

Role Description

We are seeking a versatile Medical Biller & Administrative Specialist to support our busy Ophthalmology practice. This role is unique in that it combines the technical precision of the Revenue Cycle (AR, Claims, Denials) with the patient-centric flow of Front Office Administration.

The ideal candidate is a "Hybrid VA" who understands the nuances of vision-related medical coding and is equally comfortable navigating AthenaHealth to troubleshoot a denied claim or provide a warm experience for a patient on the phone.

Key Responsibilities

• Revenue Cycle Management (RCM)
  • Claims & Denials: Manage the full lifecycle of insurance claims, including scrubbing, submission, and aggressive follow-up on rejected or denied claims.
  • A/R Management: Review Aging Reports to identify outstanding balances and execute recovery strategies.
  • Appeals: Draft and submit clinical appeals for denied Ophthalmic procedures (e.g., injections, surgeries, or diagnostic imaging).
  • Payment Posting: Accurately post insurance payments and patient co-pays within AthenaHealth.
• Front Office Administration
  • Patient Scheduling: Manage a high-volume surgical and routine exam calendar, ensuring appointments are optimized for provider flow.
  • Inbound/Outbound Calls: Serve as a primary point of contact for patient inquiries, scheduling requests, and general practice questions.
  • Insurance Verification: Perform real-time eligibility checks and explain out-of-pocket costs or vision vs. medical insurance differences to patients.
  • Chart Readiness: Ensure all patient charts are prepped with necessary authorizations and referrals prior to the date of service.

Qualifications

• Specialty Experience: Minimum of 2 years in Ophthalmology. You must understand terms like IOLs, Macular Degeneration, Glaucoma, and the difference between routine vision and medical eye care.
• Software Mastery: AthenaHealth proficiency is mandatory. You should be comfortable navigating the claim center, scheduling modules, and patient buckets.
• Billing Knowledge: Deep understanding of ICD-10 and CPT coding specific to eye care.
• Communication: Exceptional English verbal and written skills. You must be able to explain complex billing issues to patients with empathy and clarity.

Benefits

• Full-time
• Competitive compensation based on experience
• Opportunity to work with a growing ophthalmology practice
• Training and support for continuous professional development