Revenue Cycle Management Specialist II

The Virginia Eye Institute (VEI) is hiring!  VEI is a large and dynamic practice of ophthalmologists and optometrists in the Richmond, VA area. We are searching for a full-time Revenue Cycle Management Specialist II to join our busy practice. Job Purpose The Revenue Cycle Management (RCM) Specialist II ensures efficient and accurate management of the revenue cycle process. This role involves verifying and entering charges, facilitating the timely adjudication of insurance claims to maximize reimbursement and minimize outstanding receivables. The RCM Specialist addresses and resolves issues with overdue accounts, maintains accurate records, and provides excellent customer service to patients and internal stakeholders. This position specifically focuses on biller follow-up and charge entry.   Duties and Responsibilities Review, research, code, and generate third-party billing for a medical facility. Ensure timely adjudication of insurance and third-party claims, minimizing outstanding receivables and maximizing reimbursement. Collaborate on Revenue Cycle Projects with the Revenue Cycle Billing Supervisor and/or Director. Identify, research, analyze, and correct issues with overdue/unpaid patient accounts. Compile data and produce audit reports for electronic filing. Answer questions concerning patient accounts and division/unit operations. Reconcile patient accounts with accurate backup documentation and supervisor authorization. Manage aged accounts and assigned work queues Correspond with insurance companies, hospitals, nursing homes, city and state agencies, clinical physician offices, and law firms. Respond to inquiries concerning account balances, third-party payments, etc., from patients, relatives, and third-party payers in a timely manner. Review accounts receivable aging reports and date-of-service histories for payment activity. Contact third-party payers by telephone or online for overdue payments and follow up as needed. Stay updated on regulations affecting proper coding procedures and payer policies Reconcile daily charges with provider and facility schedules. Track and resolve missing charges. Meet month-end deadlines. Post charges, process refunds, and correct system edits related to charge entry. Understand carrier submissions, edits, and rejection reports. Run and work unapplied and encounter credits reports. Resolve incoming calls with excellent customer service. Input and update payer addresses. Post payment transfers and refunds. Perform other assigned duties.   Skills and Abilities   Proficiency in Coding: Skilled in ICD-10, HCPCS, and CPT coding. Software Skills: Experienced with Windows-based applications, including Word and Excel. Medical Knowledge: Strong understanding of medical terminology. EOB Interpretation: Ability to read and comprehend Explanation of Benefits (EOB) statements. Effective communicator with strong multitasking abilities. Exceptional attention to detail.   Education High School Diploma/GED required Associate’s degree preferred Experience 2-5 years in Revenue Cycle Management within a private practice setting. Experience in Ophthalmology and familiarity with eClinicalWorks (eCW) is a plus.    Work Conditions The work environment characteristics described are representative of those an employee may encounter while performing the essential functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.  Moderate noise (i.e. business office with computers, phones and printers with light traffic). Ability to work in a confined area. Ability to sit at a computer terminal for an extended period.   Physical Requirements The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to, stand, sit; talk, hear and use hands and fingers to operate a computer and telephone keyboard. Specific vision abilities required by this job include close vision requirements due to computer work. Light to moderate lifting is required.   Supervisory Responsibilities None Certificates, Licenses, Registrations   Preferred: Certified Professional Biller (CPB) Certified Professional Coder (CPC)