[Hiring] RCM Specialist @Eye Care Partners Career Opportunities

Role Description

As a member of the Revenue Cycle Management Team, the RCM Vision Specialist is a subject matter expert regarding RCM processes and procedures necessary for EyeCare Partner Vision Practices. The RCM Specialist may be responsible for multiple elements including, but not limited to:

• Billing
• Coding
• Payment Posting
• Accounts Receivable (A/R) follow up
• Insurance claim submission
• Managing customer service requests from patients

Duties and Responsibilities:

• Prepare, review, and transmit vision claims using billing software including electronic, website submission, and paper claim processing.
• Post payments both electronically and manually into the practice management system according to set standards and productivity measures.
• Status unpaid claims within standard billing cycle timeframe.
• Timely review/handling of insurance claim denials, exceptions, or exclusions.
• Forwards requests for medical records to appropriate internal resources.
• Addresses/corrects demographic information requested by insurance company.
• Ability to read and accurately interpret insurance Explanation of Benefits (EOB’s).
• Verifying insurance payments for accuracy/compliance based on contracts to ensure correct reimbursement is received.
• Following up directly with insurance companies regarding payment discrepancies.
• Utilizing aging reports and workflow statuses to address any unpaid or open claims over 30, 60, 90, and 120 plus.
• Coordination of Benefits (COB) – Ability to identify and bill secondary or tertiary.
• Documenting denials associated with patient responsibility to forward to the collection team.
• Ability to research and appeal denied claims.
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
• Report payment discrepancies or denial trends identified to Supervisor as soon as they are identified for assigned accounts.
• Keep supervisor abreast weekly of any concerns or issues associated with accounts.
• Adhering to company standards of compliance with policies and procedures.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization.

Qualifications

• High School Diploma or GED
• CPC, RHIT, CCS, or CMC Coding Credentials preferred

Requirements

• 3+ years of Medical Insurance Billing. Ophthalmology Practice preferred.
• Experience with CPT and ICD-10; Familiarity with medical terminology.
• Knowledge of billing procedures and collection techniques.
• Strong written and verbal communication skills.
• Detail oriented, professional attitude, reliable consistent production results.
• Logical, critical thinking, and research skills.
• Excellent organization, time management, and prioritization skills.
• Professional in appearance and actions.
• Customer-focused with excellent written, listening, and verbal communication skills.
• Enjoys learning new technologies and systems.
• Exhibits a positive attitude and is flexible in accepting work assignments and priorities.
• Meets attendance and tardiness expectations.
• Management and organizational skills to support the leadership of this function.
• Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations.
• Interpersonal skills to support customer service, functional, and teammate support needs.
• Able to communicate effectively in English, both verbally and in writing.
• Intermediate computer operation proficiency with Microsoft Excel, Word, PowerPoint, and Outlook.
• Practice management software and clearing houses experience.
• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines.

Company Description

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum.