Senior Medical Billing Specialist

United States
Full Time
Experienced

Senior Medical Billing Representative
Ophthalmic Consultants of Boston (OCB)

Be Part of a Team That’s Advancing Vision Care—and the People Behind It

At Ophthalmic Consultants of Boston (OCB), we don’t just deliver exceptional eye care—we build careers. As a nationally recognized leader in ophthalmology, we are proud to foster a collaborative, growth-focused environment where expertise is valued and professional development is encouraged.

We are seeking an experienced and driven Senior Medical Billing Representative to join our Revenue Cycle team. In this role, you will be a key contributor to the financial health of the organization, tackling complex billing challenges, supporting team development, and helping ensure a seamless experience for our patients and providers.


What You’ll Do

As a senior member of the team, you’ll play a critical role in optimizing revenue cycle performance by:

  • Resolving complex claim edits, rejections, and denials with accuracy and efficiency
  • Leading advanced A/R follow-up efforts to ensure timely reimbursement
  • Analyzing denial trends and implementing proactive solutions
  • Writing detailed, effective appeal letters aligned with clinical documentation and payer policies
  • Ensuring compliance with timely filing requirements and regulatory standards
  • Reviewing and validating patient demographics, insurance details, charges, and coding
  • Serving as a subject matter expert for billing processes, coding, and payer requirements
  • Collaborating with insurance carriers, patients, physicians, and internal teams to resolve complex inquiries
  • Supporting accurate eligibility verification, authorizations, and referral processes
  • Reviewing medical records to ensure alignment with medical necessity guidelines
  • Identifying workflow improvements to reduce denials and increase efficiency
  • Assisting with onboarding, training, and mentoring of new team members

What You Bring

You are a knowledgeable and detail-oriented billing professional who thrives in a fast-paced, high-volume environment and enjoys sharing your expertise with others.

  • Strong knowledge of medical terminology, ICD-10 diagnosis codes, and CPT-4 procedure codes
  • Advanced understanding of coding modifiers and their appropriate use
  • Several years of experience in medical billing or revenue cycle operations
  • Proven expertise in A/R follow-up and denial management
  • Deep understanding of insurance eligibility, benefits, and reimbursement processes
  • Familiarity with payer medical necessity requirements and billing policies
  • Excellent communication and customer service skills
  • Strong analytical, organizational, and problem-solving abilities
  • High attention to detail and accuracy
  • Ability to manage multiple priorities effectively
  • Proficiency with Microsoft Office (Word, Excel, Outlook)
  • Solid understanding of HIPAA regulations
  • College degree preferred
  • CPC, COPC, or similar certification preferred

Why Join OCB?

At OCB, your work has purpose. Behind every claim you resolve is a patient receiving life-changing care. We are committed to supporting our employees with opportunities for growth, a team-oriented culture, and the tools needed to succeed.

OCB offers industry leading benefits including:

  • Medical & dental insurance (starts on the 1st day of employment!)
  • 401(k) plan with Company match
  • Company paid Life Insurance
  • Company paid Long Term Disability
  • Eye care discounts
  • Generous Paid Time Off and Paid Holidays

To learn more about OCB, please visit our website at www.eyeboston.com

#seabrighterfuture

#OCBjobs

Share

Apply for this position

Required*
We've received your resume. Click here to update it.
Attach resume as .pdf, .doc, .docx, .odt, .txt, or .rtf (limit 5MB) or Paste resume

Paste your resume here or Attach resume file