Medical Billing Specialist

Roles & Responsibilities:

1. OHIP Billing:

• Prepare and submit bills to OHIP for services rendered to eligible patients.
• Verify patient information, treatment details, and OHIP coverage.
• Ensure adherence to OHIP billing codes and documentation requirements.

2. Claims Processing:

• Review patient records and encounter forms to generate accurate claims.
• Validate diagnosis codes, procedure codes, and other relevant information.
• Address any discrepancies or missing data promptly.

3. Follow-Up and Reconciliation:

• Monitor claim status and follow up on outstanding payments.
• Reconcile payments received from OHIP with billed amounts.
• Investigate and resolve any billing-related issues.

4. Documentation and Reporting:

• Maintain organized records of billing transactions.
• Generate reports on billing activity, reimbursement rates, and trends.
• Collaborate with clinic staff to ensure accurate data entry.

5. Compliance and Training:

• Stay informed about OHIP updates, fee schedules, and billing changes.
• Assist colleagues in understanding billing processes and requirements.
• Uphold confidentiality and ethical standards in handling patient information.

Required Candidate Profile:

• You have excellent spoken English and written skills.
• Proficient in computer and electronic communications - required
• Previous experience in diagnostic billing-related roles - required
• You are familiar with healthcare regulations like HIPAA.
• You have attention to detail and perform all tasks with high accuracy - required
• You own a computer with 2.4 GHz Processor and 8 GB RAM, and at least 100 Mbps internet connection.

Nice to have:

• US/Canada healthcare professional experience
• Healthcare-related certifications/degrees (India or North America)
• Knowledge about Optometry/Ophthalmology

Kluvor is an equal opportunity employer and makes decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law. Offer of employment with Kluvor is conditioned upon the successful completion of a background verification check, subject to applicable laws and regulations.