RCM OPH/RCM Specialist-Vision
Core
Revenue Cycle Management Specialist for ophthalmology practices, handling billing, coding, payment posting, and accounts receivable follow-up.
Role type
Senior IC medical billing specialist (ophthalmology)
Builds
Cleaned claims and collected payments for vision care practices
Domain
Healthcare + Medical Billing
Required skills
CPT and ICD-10 coding, medical terminology, insurance claim submission, payment posting, accounts receivable management, denial management, Coordination of Benefits (COB), HIPAA compliance, Microsoft Excel, practice management software
Preferred skills
CPC, RHIT, CCS, or CMC coding credentials, ophthalmology practice experience
Technologies
Electronic billing software, clearing houses, practice management systems, Microsoft Office suite
Responsibilities
Prepare, review, and transmit vision claims; Post payments electronically and manually; Status unpaid claims within standard billing cycle timeframe; Review/handle insurance claim denials, exceptions, or exclusions; Address demographic information requested by insurance companies; Verify insurance payments for accuracy/compliance; Follow up directly with insurance companies regarding payment discrepancies; Utilize aging reports to address unpaid claims; Document denials associated with patient responsibility; Answer patient or insurance telephone inquiries; Report payment discrepancies or denial trends to Supervisor.
Seniority
Mid-level, hands-on IC
