EyeSouth Partners LLC
Join Houston Retina Associates
At Houston Retina Associates, we're more than a leading ophthalmology 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. Our culture is built on collaboration, innovation, and continuous learning. We value every team member's contribution and provide opportunities for professional growth in a supportive environment. With multiple locations across the greater Houston area, we're proud to serve our community and make a meaningful impact every day. If you're passionate about excellence in patient care and want to be part of a team that truly makes a difference, we invite you to join our team!
Houston Retina Associates is affiliated with EyeSouth Partners' premier network of medical and surgical specialty eye care services.
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.
This is a Hybrid Position, the A/R Specialist will be expected to work in person at our Houston Office one day a week.
**Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Michigan, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Thank you for your interest.
* 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 r esponds 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
* 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
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
At Houston Retina Associates, we're more than a leading ophthalmology 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. Our culture is built on collaboration, innovation, and continuous learning. We value every team member's contribution and provide opportunities for professional growth in a supportive environment. With multiple locations across the greater Houston area, we're proud to serve our community and make a meaningful impact every day. If you're passionate about excellence in patient care and want to be part of a team that truly makes a difference, we invite you to join our team!
Houston Retina Associates is affiliated with EyeSouth Partners' premier network of medical and surgical specialty eye care services.
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.
This is a Hybrid Position, the A/R Specialist will be expected to work in person at our Houston Office one day a week.
**Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Michigan, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Thank you for your interest.
* 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 r esponds 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
* 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
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