Billing Specialist Assistant (4722C), Optometry Clinic - #84379

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Departmental Overview

At the Wertheim School of Optometry & Vision Science, as part of a world-renowned university that embraces excellence and access, we foster an environment of trust and mutual respect, free expression and inquiry, and personal resilience and achievement. We demonstrate sensitivity and understanding of the diverse academic, socioeconomic, cultural, disability, gender identity, sexual orientation, and ethnic backgrounds present in our community. These principles serve us daily in our reasoning and actions and aid us in our decision making.

We educate an estimated 320 students annually. Our O.D. program is a 4 year program with clinical training provided at 2 campus clinics, 10 satellite clinics (community care), 7 VA clinics, and 24 external clinics across the country. Our one-year post-graduate residency programs provide advanced clinical education in specialty areas of optometry with placement on and off campus and our Vision Science program averages 40 PhD students.

The Optometry Clinic provides comprehensive optical care services to the entire Campus population and the general Bay Area community, with approximately 80,000 annual visits to Optometry Clinics at Minor Hall and the Tang Center. The Optometry Clinic is open 7 days per week and approximately 358 days per year.

Position Summary

Reporting to the Billing and Collections Manager, the billing specialist will provide patient, third party, government, physician billing and collections activities.

Application Review Date

The First Review Date for this job is: 03/03/2026.

Responsibilities

Prepare and submit insurance claims to medical and vision insurance providers as well as produce patient statements.

• Assist in verifying completeness and accuracy of charge captured information by reviewing daily schedule and charts for appropriateness and completeness of charges, PQRS and meaningful use data.
• Using the Practice Management System, generate and scrub claims resolving issues in a timely manner.
• Generate claims batches and transmit to carrier electronically.
• Review claims transaction reports to capture detail related to denials.
• Identify and make corrections to denials, alerting Clinic Administration, IT of chronic denials due to coding errors.
• Resolve issues related to rejected claims and rebill claims.
• Review and resolve any claims that have been on HOLD status to resolve payment or billing issues.
• Send statements to patients.

Process EOB's and monitor claim and patient payments.

• Post payments to visits in the electronic medical records system upon receipt of payment for claims.
• Process claim balances to secondary payors or patient balances as required.
• Correct and resubmit denied claims as required.
• Monitor unpaid claims and follow up with insurance carriers in a timely manner to insure payment.
• Monitor delinquent patient accounts and convert to collections as required.
• Generate regular reports on the status and completeness of insurance and patient responsible balances, payments, adjustments and write offs.

Follow-up/Collections:

• Conducts follow-up on accounts and evaluates appropriate follow-up action in a stratified manner by modified account balance as assigned through monthly ad-hoc reports to achieve weekly and monthly goals.
• Complies with the rules and regulations of different payers such as Medicare, Medi-Cal, HMOs, commercial payers, Workers Compensation, and government agencies.
• Interprets and enters detailed online notes to understand past activity and provide an audit trail for future follow-up.
• Communicates effectively with payers, patients, clinic chiefs, and outside billing agents.
• Performs all follow-up necessary to track missing payments and utilizes various systems such as Compulink, Epic, Microsoft Outlook, government, and non-government websites for detailed follow-up.
• Coordinates and collaborates with supervisor and/or Manager to resolve and problem solve billing issues.
• Reviews non-payment and/or incorrect payment(s) for possible appeal.
• Requests restoral of contractual allowances or adjustments to initiate appeals as warranted.
• Prepares appeal letters to payers requesting additional payment and retrieves necessary information to support appeal letter.
• Performs proactive follow-ups for all appeals submitted.
• Analyzes Explanation of Benefits (EOB) for accurate posting of rejections, adjustments, and any other posting requirements and notifies manager of refunds, adjustments, and transfers as needed.

Correspondence/Denials:

• Secures guarantor/patient demographic and/or insurance information as required.
• Responds and resolves inquiries that may include billing policies and procedures, pricing, and coding.
• Resubmits bills to payers in a timely manner and in accordance with department and payer requirements.
• Processes denials as required in accordance with departmental procedures.
• Retrieves reports and/or additional information from various sources.
• Prepares appeals on denial(s) as warranted and initiates write off request(s) if appropriate.
• Notates activity performed for denial(s) processed and maintains records of all processed denial/appeal(s) for tracking and reporting purposes.

Other duties as assigned, which may include the following:

• Assist in credentialing/paneling faculty with insurance carriers.
• Maintain accurate rosters of providers per insurance carriers as assigned.
• Communicate roster status as required to insure patients are scheduled with credentialed providers.
• Train peers and/or clinic colleagues (faculty, staff, students) as necessary.
• Monitor billing email and assist with patient correspondence in a timely manner.

Assist in credentialing/paneling faculty and residents with insurance carriers

• Maintain accurate rosters of providers per insurance carriers as assigned.
• Communicate roster status as required to insure patients are scheduled with credentialed providers.
• Coordinated review of new and separating providers.

Referrals and Insurance Authorizations

• Monitor appointments for patients with medical PPO or HMO insurance, acquire authorizations and referrals as required.
• Communicate patient financial responsibilities to appropriate parties.

Daily Cash Deposits

• Reconcile cash, checks, and credit card payments from the previous day to Eyecare daily payment report.
• Reconcile Daily Parking tickets to parking report in Eyecare.
• Prepare Deposit Report for internal reporting.
• Prepare Deposit Bag for the bank, and submit Deposit to campus following best practices and guidelines.

Required Qualifications

• Thorough knowledge in administrative procedures and processes including word processing, spreadsheet and database applications.
• Requires good verbal and written communication skills, active listening, critical thinking, multi-task and time management skills.
• Requires interpersonal and work leadership skills to meet
• High school diploma and/or equivalent experience/training and a minimum of two years of experience in medical billing.
• Previous work experience that required knowledge of physician billing procedures including charge entry, payment posting and claim follow-up.
• Excellent verbal and written language skills
• Must be reliable, dependable and must have an excellent attendance history.
• Full knowledge of ICD-10 (9) CPT, HCPCS.
• EHR experience with platforms such as Compulink Advantage and Epic.
• Experience with insurance verification, authorization, claim submission and follow up process.
• Understanding Medi-cal, Blue View Vision, Private insurance, VSP, Vision Plans, EOB's, payment polices, rules and regulations.
• Must be results driven and customer service oriented.
• Knowledge of security and privacy regulations, HIPAA compliance.

Salary & Benefits

For information on the comprehensive benefits package offered by the University, please visit the University of California's Compensation & Benefits website.

Under California law, the University of California, Berkeley is required to provide a reasonable estimate of the compensation range for this role and should not offer a salary outside of the range posted in this job announcement. This range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to experience, skills, knowledge, abilities, education, licensure and certifications, analysis of internal equity, and other business and organizational needs. It is not typical for an individual to be offered a salary at or near the top of the range for a position. Salary offers are determined based on final candidate qualifications and experience.

The budgeted hourly rate that the University reasonably expects to pay for this position is $31.23 (Step 2).

• This is a full-time (40 hours/week), career position that is eligible for UC Benefits.
• This is a non-exempt, biweekly-paid position.

How to Apply

• To apply, please submit your resume and cover letter.

Other Information

• This position is governed by the terms and conditions in the agreement for the Clerical & Allied Services Unit (CX) between the University of California and Teamsters Local 2010. The current bargaining agreement manual can be found at: http://ucnet.universityofcalifornia.edu/labor/bargaining-units/cx/index.html
• This is not a visa opportunity. This position does not include sponsorship of a new consular H-1B visa petition that would require payment of the $100,000 supplemental fee.

Conviction History Background

This is a designated position requiring fingerprinting and a background check due to the nature of the job responsibilities. Berkeley does hire people with conviction histories and reviews information received in the context of the job responsibilities. The University reserves the right to make employment contingent upon successful completion of the background check.

Misconduct

SB 791 and AB 810 Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

"Misconduct" means any violation of the policies or laws governing conduct at the applicant's previous place of employment, including, but not limited to, violations of policies or laws prohibiting sexual harassment, sexual assault, or other forms of harassment, discrimination, dishonesty, or unethical conduct, as defined by the employer. For reference, below are UC's policies addressing some forms of misconduct:

UC Sexual Violence and Sexual Harassment Policy

UC Anti-Discrimination Policy

Abusive Conduct in the Workplace

Equal Employment Opportunity

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.