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National Vision Inc. · 1 day ago

Managed Care Billing Analyst

2000 Newpoint Pkwy, Lawrenceville, GA 30043, USA

Full-time

Hybrid

Entry, Mid Level

2+ years exp

National Vision Inc. is one of the largest optical retail companies in the United States, dedicated to making quality eye care and eyewear more affordable and accessible. The Managed Care Billing Analyst plays a critical role in ensuring the seamless processing of billing transactions between the company and managed care organizations, focusing on billing infrastructure, EDI, and API technologies.

EyewearRetail

Responsibilities

Coordinate and manage the end-to-end billing infrastructure for managed vision care plans, focusing on point-of-sale calculation, claim submission, payment posting, and reconciliation accuracy

Set up and maintain managed vision care plan calculations of customer responsibility and insurance payments in the point of sale system

Utilize EDI platforms to transmit and receive healthcare claims, remittance advices, and eligibility verifications; troubleshoot and resolve EDI transaction errors

Integrate and maintain API connections with payers and internal systems to automate data exchange and enhance process efficiency

Collaborate with IT, revenue cycle, and payer relations teams to ensure compliance with managed care contract requirements and industry regulations

Analyze billing data, identify trends or discrepancies to identify root causes of problems, and recommend process improvements to maximize reimbursement and reduce rejections, denials, and write-offs

Provide technical support and training to staff on EDI and API workflows

Maintain accurate documentation of billing processes, system configurations, and payer communications

Qualification

Managed care billingElectronic Data Interchange (EDI)API integrationData analysisAdvanced ExcelAnalytical skillsConsumer-centric mindsetProblem-solving skillsCommunication skillsInterpersonal skillsOrganizational skillsCollaborative approachWork independently

Required

2-4 years of experience in managed care billing, vision insurance, or healthcare logistics

Two years of college or equivalent experience in healthcare administration, business, information technology, or related field

General understanding of optical retail and managed vision care benefits

Experience in using EDI formats (e.g., 837, 835, 270/271) and understanding of HIPAA transaction standards

Experience with API protocols and integration with healthcare information systems

Excellent analytical, problem-solving, and organizational skills and attention to detail

Proven skill in analytical and critical thinking to understand complex data sources, evaluate both qualitative and quantitative information, and identify patterns and trends

Strong communication and interpersonal abilities

Collaborative approach to process changes to ensure integrity of all departmental processes

Consumer-centric mindset to deliver excellent customer experiences

Ability to work independently and collaboratively in a fast-paced environment

Advanced Excel or data analysis skills