Managed Care Biller

Job Responsibilities

The role is responsible for submitting, editing, correcting, and researching claims to ensure clean adjudication payment from all payors.

What Would You Do? The Specifics.

• Prepares and generates clean claims for submission to all payor types, including third party payors, Medicare and Medicaid. Submissions of claims to be are done via 837 electronic, CMS-1500, fax, and online web portal.
• Processes an average of 20-25 claims per hour.
• Facilitates all rejections from electronic or paper claims. Obtains information from carriers, stores, internal entities or patients when services billed are denied for reasons such as incorrect insurance information, demographic information and/or authorization. Appeals denials when necessary.
• Develops and maintains working relationships with internal/external providers to ensure billings and collections procedures are current.
• Researches and resolves all zero payment explanations or benefits and exercises all options to obtain claims payments; initiates adjustments as necessary.

Preferred Qualifications

Work Experience

• 2-4 years Managed Care Medical Billing and Coding  experience and/or training or equivalent combination of education and experience (Required)

Education

• High school, plus specialized schooling and/or on-the-job education in a specific skill area, e.g., data processing, clerical/administrative, equipment operation, etc. (Required)

Additional Skills

• POS system experience preferred.
• Knowledge of CPT-4, ICD0, HCPCS, and Medicare/Medical Terminology is required.

Additional Information

Taking Care of our People!

We understand the importance of financial health and security, and because of that, we provide competitive compensation to all associates. We also offer a comprehensive benefits package including health and dental insurance, 401k retirement savings with company match, flex spending account, paid personal time off, paid company holidays, parental leave, employee eyewear discount, and much, much more. At National Vision, we strive to deliver opportunities for professional growth and long-term career fulfillment. We provide training programs and access to educational courses and pride ourselves on the ever-increasing amount of promotions from within.

We are an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, veteran status, and other legally protected characteristics.