Vision Claims Billing Specialist

Delaware Eye Care Center is searching for a skilled, full time Vision Accounts Receivable Specialist to work from our offices on Old Rudnick Road in Dover, DE. This is an in office position and not hybrid or remote. No nights, no major holidays or weekends, a robust benefits package, a team oriented working environment where you are heard and seen, respected as well as clear, attainable career ladder opportunities. 

Our top candidates will have previous, verifiable experience in vision (optometric) accounts receivable reconciliation working within a large multi-office practice and be experienced in NextGen. An Optician background would be a great candidate for us due to your billing experience. 

EyeCare Services Partners (ESP) is creating the nation’s leading eyecare services company in both quality and scale by consolidating opthalmologic and optometric practices and ambulatory surgery centers that are locally dominant and clinically differentiated. Eyecare Services Partners selects best-in-class Ophthalmic and Optometric practices that are focused on essential eye health issues. Our practice groups excel in the utilization of advanced technology and processes to provide safe and optimal outcomes for our practices. ESP and our associated practices represent a community of dedicated leaders, compassionate providers and surgeons, plus highly skilled clinical teams supporting communities and their eye care needs.

All of us at Delaware Eye Care Center are committed to inclusion and belonging. We believe today more than ever that creating an environment where everyone can bring their authentic selves to work and make it easy for others to do the same will benefit us all.  it isn’t speaking the words, but starts with a culture of caring, listening and service. We would throughly enjoy meeting with you and discussing our employment opportunities.

A Claims Billing Specialist is responsible for calling all insurance companies and utilizing online resources to check claim status, resubmit claims as necessary via paper or electronically, file appeals, track denial trending, resolve denials, and ensure maximum revenue capture. In addition, this role will facilitate the timely receipt of payments and ensure balances on accounts are correct and appropriately prorated. 

Eyecare Services Partners will now only consider candidates who can verify prior to hire that they either have been fully vaccinated against the Covid-19 virus or have started the vaccine process by having their initial dose before starting in their new position and are committed to completing that process within 30 days of starting work.

• Review encounters via NextGen, reports, and other sources with an average productivity of 50 accounts
  per day.
• Identify the root cause of insurance denials, send appeals to payors, and take appropriate actions to
  assure prompt payment.
• Document cument follow-up appropriately in the practice management system.
• Register with all necessary payor portals and submit all the required verification documents for access.
• Maintain an acceptable error rate and productivity level within department policy.
• Perform collection actions, including third-party appeals and resubmitting claims to third-party payers.
• Identify and bill secondary or tertiary insurances.
• Reconcile carrier submissions, edits, and rejection reports.
• Resolve incoming patient calls with excellent customer service skills.
• Employ tactfulness in dealing with insurance companies/patients regarding accounts in verbal and
  written communication while being professional and courteous at all times.
• Identify, verify, and document adjustments according to established policies and procedures.
• Research and prepare credits for refund approval.
• Performs all other duties as assigned by direct report.

• High School Graduate or General Education Degree (GED). Associates degree preferred
• Three years of professional medical billing and collecting experience or certification obtained from a
   nationally accredited billing program, i.e., CMBS (Certified Medical Billing Specialist) is equired
• One year of optical billing experience, including medically necessary contact lenses is required
• Experience with Excel and Windows-based programs
• Experience in performing tasks that require a basic understanding of accounting and math skills
• NextGen PM/EHR experience highly preferred
• One year of Optometry and Ophthalmology third-party billing guidelines and expertise

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