Optical Billing Associate

Overview

This role involves managing the daily acceptance and billing of optical charges for assigned providers or modalities. The Optical Billing Associate will follow established processes to accept, correct, investigate, and bill charges, as well as manage accounts receivable (AR) for their assigned area. Responsibilities include investigating denials, making necessary claim adjustments, and resubmitting claims to payers. Familiarity with Nextgen tasking, Waystar workgroups, and payer websites is essential to efficiently process claims. The position reports to a billing lead.

Optical billing experience is required.

Responsibilities

• Utilize billing systems such as Nextgen, Waystar, and Clearwave to bill insurance claims, manage denials, and handle AR (training provided).
• Collaborate with the Financial Services Team to assist patients with billing inquiries.
• Update patient demographics and insurance information to ensure accurate billing for primary and secondary coverages.
• Process large volumes of claims efficiently.
• Correct patient records to ensure future claims and statements are accurate.
• Contact insurance companies to clarify denials and determine necessary actions for payment.
• Review, correct, and process charges for assigned providers or clinics.
• Work denied claims promptly to maintain key performance indicators related to aged AR.
• Communicate with other billers and billing leads to identify error and denial trends and address root causes.

Requirements

• Optical billing experience is mandatory.
• Positive attitude and willingness to learn.
• Basic computer skills required.
• Experience with Excel, Word, and Teams preferred.
• Knowledge of medical billing, CPT, and ICD-10 codes.
• High school diploma or GED equivalent required.
• Experience in medical billing within ophthalmology is preferred.

Compensation & Benefits

• Competitive compensation package.
• Comprehensive benefits.
• 401(k) plan.
• Significant discounts on eye care.
• Continuing education allowances.
• Opportunities for career growth and development.
• Paid time off and holidays.

Equal Opportunity

The employer is an equal opportunity organization and considers all qualified applicants without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.