JOB SUMMARY: Oversees the revenue cycle management related to Ophthalmic Injectable Drugs e.g. Lucentis, Eylea, etc. Tasks include, but are not limited to: the retrieval of preauthorization’s, working with the chronic disease fund, charge entry, posting of payments, A/R, etc. This individual is responsible for accurately billing patients and insurance carriers as well as maximizing payment amount and turn-around time.
ESSENTIAL SKILLS AND ABILITIES:
a. Demonstrated ability to work well and get along with co-workers.
b. Initiative to complete projects.
c. Excellent communication skills, written and oral.
d. Strong organization skills with attention to detail.
e. Excellent follow-up skills.
f. Management of multiple tasks simultaneously.
1. Maintenance of patient calendars in order to ensure all pre-authorizations are obtained prior to patients scheduled DOS.
2. Monitors daily appointment schedules to become aware of scheduled patients with open balances exceeding 30 days; calls patients prior to their arrival.
3. Posts all insurance payments on a daily basis.
4. Maintains a monthly account of receivables over 30, 60 and 90 days, seeing that over-due accounts are addressed within the policy and procedures.
5. Remedies any previously approved insurance claim that has subsequently been denied.
6. Handles all patient complaints regarding billing in a timely and consistent manner.
7. Coordinates all patient and insurance refunds.
8. Coordinates all necessary patient forms are properly obtained. e.g. SPOC
9. Enters all charges and credits daily.
A strong familiarity with navigating billing software and a medical billing background are required.