EyeCare Partners
Finance / FinServ
RCMSpecialist
Neural analysis suggests this role is
optimal for Mid+ candidates.
“RCM Specialist at EyeCare Partners. Skills: Revenue Cycle Management (RCM), Billing, Coding, Payment Posting, Accounts Receivable (A/R) follow up, Insurance claim submission. Prepare, review, and transmit claims using billing software. Post payments both electronically and manually into the practice management system”
What You'll Achieve.
Consistent production results
Industry & Context.
Logical thinking; Critical thinking; research skills
Ability to work in a remote environment, Travel to other locations may be necessary, Dependable transportation required for travel, Driving record must meet company liability carrier standards, HIPAA compliant home office environment required for remote team members, Able to work varying shifts including early mornings/evenings
What They're Looking For.
Must Have
Familiarity with medical terminology, Knowledge of billing procedures and collection techniques, Ability to work in a remote environment while performing required duties and remaining patient focused
Nice to Have
HIPAA guidelines
What You'll Do.
and transmit claims using billing software
Post payments both electronically and manually into the practice management system
Status unpaid claims within standard billing cycle timeframe
Timely review/handling of insurance claim denials
Forward requests for medical records to appropriate internal resources
Address/correct demographic information requested by insurance company
Read and accurately interpret insurance Explanation of Benefits (EOB’s)
Verify insurance payments for accuracy/compliance based on contracts to ensure correct reimbursement is received
Follow up directly with insurance companies regarding payment discrepancies
Utilize aging reports and workflow statuses to address any unpaid or open claims over 30
Identify and bill secondary or tertiary claims (Coordination of Benefits)
Document denials associated with patient responsibility to forward to the collection team
Research and appeal denied claims
Answer all patient or insurance telephone inquiries pertaining to assigned accounts
Report payment discrepancies or denial trends identified to Supervisor
Keep supervisor abreast weekly of any concerns or issues associated with accounts
Adhere to company standards of compliance with policies and procedures
Adhere to all safety policies and procedures
Perform other duties that may be necessary or in the best interest of the organization
How You'll Work.
Team & Collaboration
Forward requests for medical records to appropriate internal resources; Report payment discrepancies or denial trends identified to Supervisor; Keep supervisor abreast weekly of any concerns or issues associated with accounts
Communication Scope
written communication skills; verbal communication skills; listening skills
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 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 unpaid or open claims over 30, 60, 90, and 120 plus • Coordination of Benefits (COB) – Ability to Identifying and
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