Certified Ophthalmic Coder, Billing Coordinator – Retina

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Analyze clinical documentation in real-time to accurately code complex retina visits, surgical procedures, and J-codes for intravitreal injectable drugs, adhering to precise ICD-10 and CPT coding standards.

• Accurately post payments from ERAs/EOBs, reconcile accounts, and conduct audits on payment postings to identify discrepancies in fee schedules or coding-related claim denials.

• Collaborate directly with the practice manager and the outsourced billing agency to monitor unbilled encounters, resolve coding denials, facilitate claim corrections, and report on outstanding revenue items.

• Perform real-time CPT and ICD-10 coding for clinical encounters, retinal procedures, intravitreal injections, and specialized diagnostic tests.

• Ensure accurate coding and compliance for high-cost ophthalmic drugs and biologic injectables (J-codes), confirming unit quantities and the correct application of modifiers.

• Review provider chart documentation against submitted codes to identify unbilled services, detect clinical discrepancies, and maintain billing integrity before claim submission.

• Post electronic and manual payments, identify discrepancies at the line-item level, and address coding-related denials or payer bundling rejections.

• Act as the primary liaison for the third-party billing company—monitoring claim transmission schedules, resolving coding edits, and ensuring accountability among external billers.

• Manage all coding workflows, provide weekly transparent status reports on pending charts, and directly alleviate administrative bottlenecks for clinic leadership.

⛳️ Requirements

• 5+ Years Ophthalmology Coding Experience: Significant, demonstrated experience coding for an ophthalmology practice, with a focus on retina coding.

• Active Medical Coding Certification: Must possess an active credential such as CPC (Certified Professional Coder), COC, CCS, or COA/OCP (Ophthalmic Coding Specialist).

• Live-Coding & J-Code Mastery: Proven proficiency in real-time live coding of provider notes and a strong understanding of J-codes / injectable drug coding.

• CPT & ICD-10 Expertise: In-depth knowledge of ophthalmic CPT codes, modifiers, ICD-10 diagnostic codes, and payer LCD/NCD coverage policies.

• Payment Posting & Billing Operations: Practical experience with payment posting, EOBs/ERAs analysis, and auditing patterns of claim denials.

• Schedule Availability: Must be available to work 40 hours per week, Monday through Friday, from 8:00 AM to 5:00 PM PST.

• Remote Workspace Setup: A dedicated, private home office with a lockable door, a high-speed primary internet connection, backup power/internet solutions, a high-performance computer (PC/Mac), and a noise-canceling headset, all in compliance with HIPAA regulations.

• Preferred: Direct coding experience for intravitreal injections, retinal detachments, laser surgeries, and complex retinal imaging.

• Preferred: Proficiency with ModMed (Modernizing Medicine / EMA) or DrChrono EHR systems.

• Preferred: Previous experience coordinating workflows with an outsourced third-party billing agency.

• Preferred: Experience directly supporting an ophthalmology practice manager or clinic director.

🏝️ Benefits

• Competitive salary commensurate with experience.

• Flexible work hours with the possibility of remote work.

• Opportunities for professional development and continuing education.

• Supportive and collaborative work environment.