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Company Name :
Associated Retinal Consultants
Location : Novi, MI 48377
Position :

Job Description : Associated Retinal Consultants, P.C.

Position Description

POSITION: Medical Biller and Collections Analyst


In a centralized billing department and under the direction of the RCM COE Manager, the Medical Biller and Collections Analyst ensures appropriate and accurate processes are followed and secured to optimize reimbursement for services rendered throughout Associated Retinal Consultants and Eye Care Partners. Employee must maintain accuracy in preparing patient billing statements and be able to accurately bill and collect for most major insurance payer categories (Medicare, Blue Cross, Medicaid, Commercial, HMO, Workman’s Compensation, Nursing Home, etc.) via electronic billing systems. Must demonstrate excellent communication and negotiation skills, particularly when dealing with patients regarding their billing statements. A high level of professionalism and trustworthiness must be always exhibited. The duties of a Medical Biller and Collections Analyst include making collection calls, using payer websites, and generating correspondence in a fast-paced, goal-oriented collections department.


Ø Monitor, track and correct claim denials and unpaid claims daily to ensure timely processing of claims utilizing up-to-date electronic claims filing procedures whenever possible.

Ø Maintain current knowledge of retina coding guidelines including correct modifier use, ICD 10 coding and CPT/HCPCS use.

Ø Maintain a level of unpaid claims at 120+ days that are less than 5% of the total Accounts Receivable. Reduce delinquency for assigned accounts.

Clearly communicate to supervisor in a timely manner any issues with payers, contracts, coding, or front office data input.
Maintain current information regarding reimbursement requirements for all payers needed to efficiently submit accurate claims.
Maintain and monitor assigned payer and patient accounts to identify unpaid balances. Investigate historical data and seek resolution. Reconcile customer disputes as they pertain to outstanding balances. Activities will include customer calls, account adjustments, small balance write-offs, customer reconciliations, processing of credit memos and credit card payments.
Coordinate with clinic staff to obtain necessary documentation needed to submit or appeal claims.
Scan and import correspondence, documents, and other applicable information into practice management/EMR programs.
Maintain documentation in practice management system Notes and Referral tabs regarding conversations with patients, payers, pre-authorizations, pre-certifications, eligibility, and benefits; this includes any tasks that are required from clinic staff to ensure correct payment for procedures and specialty drugs.
Correspond with patients regarding status of their accounts and their responsibility for outstanding balances regardless of insurance payers. Process payments and refunds and set up payment plans during patient telephone calls.
Provide exceptional customer service regarding collections issues.
Maintain accurate records and reports on collection activity, update account status records, report on collection activity and accounts receivable status.
Coordinate information with Drug Reimbursement Specialist to obtain proper claim denials to submit for vial replacement coverage, if applicable.
Act as liaison between all payers, patients, physicians, and staff to answer any questions regarding insurance coverage and resolve any outstanding claims.
Build and maintain strong relationships with the third-party payer community in addition to problem solving any issues associated with processing claims.
Complete assigned tasks and projects by established deadline
Investigate solutions to problems and determine best course of action
Work effectively in a team environment.
Perform all other duties as assigned, which may include assisting in other departments within Associated Retinal Consultants.

Minimal educational requirement: high school diploma
Minimum of 2 years Medical Billing experience.
Demonstrated ability to efficiently and effectively utilize the Practice Management system capabilities i.e., running reports, navigation of screens, modify patient accounts, etc.
Excellent interpersonal and professional skills to work effectively with others (teamwork) and provide superior customer service to patients.
Ability to handle confidential matters; adheres to all HIPAA guidelines/regulations.
Basic knowledge of 1500 claim form and understanding of payer EOBs.
Understand medical terminology, procedure codes and diagnosis codes as they apply to insurance c
Communicate clearly and professionally, both orally and in writing with patients, team members, physicians, payers, and office coordinators. Knowledge of correct and proper spelling, punctuation, grammar, sentence structure, and English usage
Ability to multitask duties, prioritize workload, organize files and workspace and be self-directed in an open office setting.
Strong proficiency in MS Office Suite including Word, Excel, and Outlook or other email system; use of computerized medical billing systems; use of insurance websites; internet search capabilities; and other applications as appropriate.
Strong analytical and problem-solving skills.


Reports to: Reports to RCM COE Manager.

Directly Supervises : Not applicable

Work Schedule: Varies, but typically Monday through Friday. Potential for Saturday work hours depending on workload.

FLSA Status : Non-exempt

Minimal physical activity (standing, bending, sitting, walking, pulling, and lifting) for most of the work shift.
Clean office environment.
Possible hazardous chemicals.

If you need assistance with this application, please contact (636) 227-2600

Please do not contact the office directly – only resumes submitted through this website will be considered.

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.

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By Richard