Billing and Medical Authorization Specialist

Job Description

Primary Job Responsibilities:

As a Billing & Authorization Specialist at 20/20 Image Eye Centers, you will be responsible for obtaining medical benefits, submittal of current insurance claims, and the researching of outstanding insurance balances.

Medical Authorizations:

Prior to a patient’s appointment, you will obtain a statement of benefits (including copayments, deductibles, and plan exclusions) from the insurance carrier and input benefits into the patient’s file.
Authorizations will be done through phone calls, and insurance websites.
Communicate with office staff members ALL issues that arise during the authorization process to ensure proper patient care.

Insurance Billing:

Keep current on applicable medical and vision billing:

Submittal of claims in a timely manner
Maintain Gateway EDI rejections and resubmissions
Constantly work outstanding Medical and Vision AR balances
- Research outstanding aging balances by making phone calls, establishing contacts and/or relationships with insurance representatives to ensure that the company receives all monies due
Submit pre-existing questionnaires as requested by the insurance
Submit medical records as requested by the insurance

Skills & Responsibilities

This position requires a wide variety of skills, including the ability to multi-task and stay organized. You will be expected to research, review and analyze data. This position also requires superior written and oral communication skills that allow you to interact effectively with medical personnel, insurance companies, and patients over the phone and by email to discuss accounts, and resolve problems.