Medical Biller (Long Term Temporary)

Job Title: Medical Biller (Long-Term Temporary)

Pay: $22$24 per hour
Schedule: MondayThursday 9:00 AM5:00 PM (PST); minimum 20 hours per week within this window
Location: Onsite (Kent WA)

Start Date: Immediately
Employment Type: Long-term temporary / part-time (3-6 Months)

About the Role

Simply Great Staffing is seeking a detail-oriented Medical Biller with hands-on optometry coding experience to support end-to-end revenue cycle activitiessubmitting clean claims managing accounts receivable driving denial resolution/appeals and assisting with patient scheduling and occasional phone reception. The ideal candidate thrives in a fast-paced clinic environment understands Medicare Advantage payer policies and consistently delivers high first-pass claim acceptance rates.

Key Responsibilities

Coding & Charge Capture

• Accurately code optometry encounters using ICD-10-CM CPT and HCPCS guidelines (e.g. comprehensive/ intermediate eye exam codes diagnostic imaging treatments).
• Review provider documentation for completeness; query clinicians to resolve discrepancies before submission.
• Post charges modifiers place of service and attach required documentation (e.g. authorization medical necessity).

Claims Submission & Reconciliation

• Prepare and submit electronic claims via clearinghouse and payer portals; monitor rejections and correct within service-level timelines.
• Perform daily reconciliation of batches/EOBs/ERAs post payments adjustments and balance transfers.

Denials Appeals & A/R Management

• Work aged A/R (030/3160/6190/90 day buckets) to reduce days outstanding.
• Investigate denials (eligibility coordination of benefits prior auth medical necessity bundling NCCI edits modifier issues) and file timely well-supported appeals.
• Track trends by payer and reason code; recommend preventive fixes (coding edits documentation prompts front-end eligibility checks).

Medicare Advantage Expertise

• Verify eligibility benefits and plan specifics; confirm authorizations/referrals; apply MA billing rules (e.g. network requirements cost-share pre-certs).
• Adjust workflows to payer-specific guidelines; maintain current knowledge of MA updates impacting optometry services.

Patient Scheduling & Front Office Support

• Appointment Making: schedule/confirm patient visits; coordinate recalls; reschedule as needed to optimize provider and diagnostic slots.
• Occasional Phone Reception: answer inbound calls route messages provide billing explanations and take payments professionally and empathetically.

Compliance & Documentation

• Maintain HIPAA privacy/security standards safeguard PHI in all workflows.
• Follow clinic policies federal/state regulations and payer contracts; maintain accurate audit-ready records.

Required Qualifications

• Direct experience coding optometry services and submitting optometry claims.
• Demonstrated denials/appeals success with commercial and Medicare Advantage plans.
• Proficiency with medical billing software clearinghouses and payer portals.
• Working knowledge of ICD-10-CM CPT HCPCS modifiers and common optometry documentation requirements.
• Strong Excel/Google Sheets skills for aging reports and KPI tracking.
• Excellent communication (written/verbal) and customer-service mindset.

Preferred Qualifications (Nice to Have)

• Experience with optometry/ophthalmology EHR & PM systems (e.g. Eyefinity/OfficeMate RevolutionEHR Compulink or similar).
• Familiarity with Epic NextGen Athena or other enterprise platforms.
• Prior work in a high-volume clinic with multi-payer A/R.
• Bilingual skills are beneficial for patient financial communications.

Core Competencies

• Accuracy & Compliance: meticulous coder with strong documentation review.
• Ownership: proactively works aging and denial queues to resolution.
• Problem Solving: identifies root causes; implements preventive fixes.
• Collaboration: partners well with providers technicians and front office.
• Professionalism: calm clear and empathetic phone presence.

Tools & Systems Youll Use

• Practice Management/EHR system (clinic standard) clearinghouse and payer portals.
• Microsoft Excel/Google Sheets for aging trend and KPI dashboards.
• Phone system/voicemail and secure payment tools.
• Secure file management aligned with HIPAA.

Success Metrics (KPIs)

• Clean-claim rate: 95% first-pass acceptance.
• A/R performance: steady reduction of >90-day buckets; maintain Days in A/R at target set by the clinic.
• Denial rate & turnaround: continued decline in denial percentage; timely appeal submissions within payer limits.
• Patient experience: positive feedback on billing explanations and scheduling interactions.

Work Environment & Physical Requirements

• Onsite professional clinical setting; extensive computer and phone work.
• Ability to sit type and speak on the phone for extended periods; handle occasional front-desk support.

Background & Confidentiality

• Employment may be contingent on background check(s) per clinic policy.
• Strict adherence to HIPAA and clinic confidentiality standards is required.

Equal Opportunity Statement

We are an equal opportunity employer. All qualified applicants will receive consideration without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other protected characteristic.

About Simply Great Staffing:

Simply Great Staffing is a leading staffing agency dedicated to connecting talented individuals with top companies. We specialize in providing personalized staffing solutions to meet the unique needs of our candidates & clients.

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Ready to take the next step in your career Apply today and join our team in Kent WA!