Job Details

The Billing Administrator plays a critical role in ensuring the financial health of the ophthalmology clinic by overseeing all billing, coding, and reimbursement functions. This position requires strong attention to detail, knowledge of medical billing practices (particularly for ophthalmology), and the ability to work collaboratively with clinical and administrative staff to maintain accurate and timely billing processes.

Key Responsibilities

• Billing & Coding
  • Accurately process and submit medical claims (electronic and paper) to insurance companies, Medicare, Medicaid, and other payers.
  • Ensure correct coding of ophthalmology procedures, tests, and services using CPT, ICD-10, and HCPCS guidelines.
  • Verify compliance with payer policies and regulatory requirements.
• Accounts Receivable Management
  • Track, post, and reconcile insurance payments and patient payments.
  • Monitor accounts receivable and follow up on unpaid or denied claims.
  • Initiate appeals for denied or underpaid claims in a timely manner.
• Patient Billing
  • Generate and send patient statements.
  • Assist patients with billing questions and establish payment plans when appropriate.
  • Collect co-pays, deductibles, and balances at the time of service.
• Reporting & Compliance
  • Prepare monthly billing and collections reports for management.
  • Maintain compliance with HIPAA, Medicare regulations, and other healthcare billing standards.
  • Participate in audits and assist with financial reporting as needed

• High school diploma or equivalent required; associate degree or higher in healthcare administration or related field preferred.
• Current medical coding certification (e.g., CPC, COC, CCS, or equivalent) is required.
• Strong understanding of medical coding (CPT, ICD-10, HCPCS).
• Minimum of 2-3 years of medical billing experience, with preference for ophthalmology or specialty practice billing.