Eye Care Partners
Healthcare
RCMOPH/RCMSpecialist-Retina
Neural analysis suggests this role is
optimal for Mid+ candidates.
“RCM OPH/RCM Specialist-Retina at Eye Care Partners. Skills: Revenue Cycle Management, Billing, Coding, Payment Posting. Prepare claims. Review claims”
Industry & Context.
Logical thinking; Critical thinking; Research skills
Reside in specific states, Dependable transportation, Valid driving record
What They're Looking For.
Must Have
Familiarity with medical terminology, Knowledge of billing procedures, Knowledge of collection techniques, Consistent production results, Ability to follow HIPAA guidelines
Nice to Have
CFA charterholder preferred
What You'll Do.
Post payments electronically
Post payments manually
Handle claim exceptions
Handle claim exclusions
Forward requests for medical records
Address demographic information
Correct demographic information
Interpret insurance EOBs
Verify insurance payments
Follow up with insurance companies
Address unpaid claims
Identify Coordination of Benefits
Research denied claims
Answer patient inquiries
Answer insurance inquiries
Report payment discrepancies
Keep supervisor abreast of concerns
Keep supervisor abreast of issues
Adhere to company standards
Adhere to compliance policies
Adhere to compliance procedures
Support a culture of high quality
Support great customer service
How You'll Work.
Team & Collaboration
Revenue Cycle Management Team
Communication Scope
Written communication; Listening skills; Verbal communication
Full Job 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. For more information, visit www.eyecare-partners.com. Job Title: RCM Specialist-Ophthalmology Must reside in the following states: AL, AZ, FL, GA, IL, IN, KS, KY, MI, MN, MO, NC, NJ, OH, OK, PA, TX, VA Job Summary As a member of the Revenue Cycle Management Team, the RCM Specialist is a subject matter expert regarding RCM processes and procedures necessary for EyeCare Partner 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 and managing customer services requests from patients. Duties and Responsibilities •Prepare, review, and transmit 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 u
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