Job Description
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.
SECTION 1 : Job Summary (Summary of the basic functions of the position)
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.
SECTION 2 : Duties and Responsibilities (Responsibilities necessary to accomplish job functions)
- 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 timeframeTimely review / handling of insurance claim denials, exceptions, or exclusionsForwards requests for medical records to appropriate internal resourcesAddresses / corrects demographic information requested by insurance companyAbility 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 receivedFollowing up directly with insurance companies regarding payment discrepanciesUtilizing aging reports and workflow statuses to address any unpaid or open claims over 30, 60, 90, and 120 plusCoordination of Benefits (COB) – Ability to Identifying and bill secondary or tertiaryDocumenting denials associated with patient responsibility to forward to the collection teamAbility to research and appeal denied claimsAnswering all patient or insurance telephone inquiries pertaining to assigned accountsReport payment discrepancies or denial trends identified.Keep supervisor abreast weekly of any concerns or issues associated with accountsAdhering to company standards of compliance with policies and proceduresAdheres 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.SECTION 3 : Patient Population Served (For nursing / patient care positions)
This position does not serve the patient populationSECTION 4 : Education
HS Diploma
SECTION 5 : Experience Requirements
3 years of Medical Insurance Billing. Ophthalmology Practice preferred.SECTION 6 : Knowledge, Skills and Abilities Requirements
Experience with CPT and ICD-10; Familiarity with medical terminologyKnowledge of billing procedures and collection techniquesStrong written and verbal communication skillsDetail oriented, professional attitude, reliableConsistent production resultsLogical, Critical thinking, and research skillsExcellent organization, time management, and prioritization skillsProfessional in appearance and actionsCustomer-focused with excellent written, listening and verbal communication skillsEnjoys learning new technologies and systemsExhibits a positive attitude and is flexible in accepting work assignments and prioritiesMeets attendance and tardiness expectationsManagement and organizational skills to support the leadership of this functionAbility to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretationsInterpersonal skills to support customer service, functional, and teammate support needAble to communicate effectively in English, both verbally and in writing
Intermediate computer operationProficiency with Microsoft Excel, Word, PowerPoint and Outlook
Practice management software and clearing houses experienceKnowledge of state and federal regulations for this position; general understanding of HIPAA guidelinesSECTION 7 : Supervisory Responsibilities :
This role does not have any supervisory responsibilitiesPhysical Requirements :
While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and / or move up to 10 pounds.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
If you need assistance with this application, please contact (636) 227-2600
EyeCare Partners is an equal opportunity / affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Please do not contact the office directly – only resumes submitted through this website will be considered.
