RCM OPH/RCM Specialist-Vision
Core
Manage revenue cycle operations for ophthalmology practices, including billing, coding, payment posting, and accounts receivable follow-up.
Role type
Senior IC revenue cycle management specialist (ophthalmology)
Builds
Cleaned accounts receivable and accurate reimbursement for vision practices
Domain
Healthcare + Medical Billing
Required skills
Medical insurance billing, CPT and ICD-10 coding, Explanation of Benefits (EOB) interpretation, Coordination of Benefits (COB), insurance claim denial appeals, practice management software, clearinghouse systems, Microsoft Excel
Preferred skills
CPC, RHIT, CCS, or CMC coding credentials, ophthalmology practice experience
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