Company Overview At Vitreo Retinal Associates, we’re more than a leading retina specialty practice—we’re a team dedicated to preserving and restoring vision for our patients. Specializing in advanced care for retinal conditions like macular degeneration, diabetic retinopathy, and retinal detachment, we combine cutting-edge technology with compassionate, personalized treatment. Position Summary This positin is based full time onsite at the Gainesville office. The A/R Specialist is responsible for the company’s third-party medical claims processing and assisting patients and office staff with questions on insurance claims, authorizations, statements, and other billing issues. This position will prepare, submit and follow-up on medical claims for Managed Care Organization (MCO), Medicaid, Medicare, Other Federal, Private Insurance, and Workers Compensation. Responsibilities • Files and processes primary and secondary third-party medical • Verifies all the information for claims processing is complete and • Contacts the appropriate person to obtain missing or unclear billing • Follows-up by website and/or telephone on all unpaid and denied claims to determine next course of action, which may require rebilling missing claims, denied claims or sending additional information on pending claims • Sends appeal letters to insurance • Obtains authorizations when needed. • Identifies and corrects charge entry/ billing • Provides proper documentation to insurance companies. • Handles insurance company questions, complaints, and/or responds to and interacts with patients concerning all aspects of billing through phone, e-mail, or regular mail in a prompt and courteous • Documents all actions and maintains permanent records of patient • Assists with answering phones, screening calls and following-up on • Works with management on patient billing and insurance • Processes refunds to patients and insurance • Works with outside programs (i.e., co-pay assistance) to ensure proper • Communicates with front office staff to attempt to collect any outstanding patient • Contributes to the team effort by completing other tasks and projects as needed Qualifications • Minimum of two (2) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system • CPC, CPOC, COC certifications a plus • Six months of previous customer service experience preferred • Prior experience with an electronic medical record system required (EHR/EMR) • Working knowledge of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; and strong knowledge of Federal payer regulations • Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes • Ability to handle sensitive and confidential information in a professional manner • Maintains knowledge of coordination of benefits requirements and processes • Demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary • Self-motivated with strong organizational skills and superior attention to detail • Ability to review documents for accuracy and reasonability • Ability to work well under pressure • Ability to multi-task, set priorities and follow through without direct supervision • Effectively communicate with physicians, patients, insurers, colleagues, and staff • Intermediate computer skills including Microsoft Office; especially Word, Excel, and PowerPoint • Knowledge of policies and procedures to accurately answer questions from internal and external customers • Detail oriented and tolerant of frequent interruptions and distractions from patients and staff • Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external • Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level • Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams Company Benefits We offer a competitive benefits package to our employees: • Medical • Dental • Vision • 401k w/ Match • HSA/FSA • Telemedicine • Generous PTO Package We also offer the following benefits for FREE: • Employee Discounts and Perks • Employee Assistance Program • Group Life/AD&D • Short Term Disability Insurance • Long Term Disability Insurance EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. #IND