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Billing Specialist - Optical Insurance

Location: Saint Petersburg
Posted on: May 20, 2023

Job Description:

Job Type




At Sight360, we are building the region's premier destination for comprehensive vision care. We are a team of over 130 optometrists, ophthalmologists, surgeons, opticians, and eye care professionals serving more than 100,000 patients across 17 different locations in the Greater Tampa Bay area. From routine eye exams and optical retail, to medical optometry, ophthalmology, and surgical procedures, our patients experience end-to-end personalized care and service.



The Insurance Billing Specialist is responsible for collecting insurance claim information from patients and entering this information in the systems of record, posting insurance and patient information, submitting claims to appropriate parties, following up with insurance carriers on unpaid or rejected claims and answering patient inquiries on account status changes in a timely manner.

Essential Functions and Responsibilities:

  • Enters information necessary for insurance claims such as patient, insurance ID, diagnosis, treatment codes, modifiers, optical material purchases, and provider information. Ensures claim information is complete and accurate.
  • Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
  • Answer patient billing questions related to copays, deductibles, write-off's, etc. Resolves patient complaints or explains why certain services are not covered.
  • Works with providers and other clinic stakeholders to gather appropriate information to ensure coding and additional information is accurate.
  • Follows HIPAA guidelines in handling patient information.
  • Post payments to payer and patient accounts in practice management system.
  • May periodically create insurance or patient aging reports using the medical practice billing software. These reports are used to identify unpaid insurance claims or patient accounts.
  • May have to verify patient benefits eligibility and coverage.
  • Ability to look up ICD 10 diagnosis and CPT treatment codes from online service or using traditional coding references.
  • Ability to inquire vision plan benefits for both medical and materials to ensure proper coding and patient collections at time of service.
  • Other duties as assigned. Position/Type/ Expected Hours of Work:
    • This is a full-time ON-SITE position and core hours of work and days are Monday through Friday 8:00 a.m. to 5:00 p.m.
    • Potential for evening and weekend hours as required. Qualifications:
      • Minimum of 2 years of medical or optical billing experience
      • Demonstrated knowledge of medical and optical materials terminology
      • Third-party payor reimbursement guidelines and requirements
      • Working knowledge of medical, accounts receivable, collections, rejects, denials, appeals, and research billing guidelines and policies
      • Experience working with confidential medical information
      • Experience in computer programs such as EMRs, Word, Excel Skills and Abilities:
        • Ability to navigate various websites and carrier portals
        • Highly organized with developed time management skills
        • Excellent customer service and telephone etiquette
        • Excellent verbal and written communication skills
        • Strong research and problem-solving skills; attentive to details
        • Ability to operate a computer and general office machines
        • Must be self-directed, able to work independently, as well as work in a team-oriented and fast paced environment Benefits:
          • Employee Recognition Programs
          • 8 Paid Holidays
          • Paid Time Off (accrues each pay period effective with your first paycheck!)
          • Medical, Dental, Vision and other programs
          • 401k (eligible after 30 days of employment)
          • 401k match (eligible after 12 months of employment)

Keywords: CLEAR SIGHT PARTNERS, LLC, St. Petersburg , Billing Specialist - Optical Insurance, Accounting, Auditing , Saint Petersburg, Florida

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