Riverside Eye Center is seeking a Revenue Cycle Specialist, to work in our Lewiston Facility. This individual will be responsible for a variety of ophthalmology-related billing tasks including charge entries, collections, and claims.
Requirements of the Revenue Cycle Specialist:
- The Revenue Cycle Specialist is responsible for charge entry, payment processing, and insurance claim follow-up on a daily basis.
- Reviews E/M, diagnostic, injection, procedural and ambulatory surgery documentation and assign correct CPT and diagnosis codes.
- Maintains oversight of both electronic and paper claims submissions, reviews rejections to resolve errors, and resubmit as required.
- Interfaces across departments to optimize coding, reduce denials, and ensure compliance with all coding rules and guidelines.
- Follow-ups on denied secondary claims, including manual entry on Mainecare secondary claims to the MIHMS portal.
- Monitors patient statements daily to ensure correct posting, follows up on outstanding patient balances, and coordinates collection efforts as required.
- Makes outbound phone calls to collect custom surgery fees prior to date of service.
- Handles inbound patient phone calls to effectively resolve billing related questions.
- Maintains spreadsheet of billed injections and reviews monthly, entering payment once paid in full.
- Once a month runs an AR report to follow up on claims pending 60+ days
- Perform other duties as needed/assigned.
Skills and Qualifications:
- Minimum 2 years of Revenue Cycle experience in a healthcare setting, strongly preferred.
- Minimum of 2 years of physician/professional coding experience with E/M services and coding in an ambulatory surgical center preferred
- Must have detailed knowledge/understanding of medical insurance structures.
- Knowledge of EyeMD PM and EHR systems is preferred but not required.
- Ability to work professionally with sensitive data & information while maintaining confidentiality.
- Knowledge of HCPCS, ICD-10 CM, medical terminology, and HIPAA regulations is preferred.
- Must manage multiple tasks/projects simultaneously within inflexible time frames.
- Ability to adapt to frequent priority changes with an evolving practice.
Benefits of the Job:
- Starting pay at $20 with up to $25 commensurate with experience.
- One day to work from home which will be coordinated upon hire.
- PTO, 9 paid holidays, 1 paid volunteer day, paid bereavement leave
- Medical benefits, Vision care
- Optional Dental, Life, and Disability insurance
- Wellness Program
Riverside Eye Center is a comprehensive eye care practice specializing in the diagnosis and treatment of medical and surgical diseases of the eye. We aim to provide state-of-the-art eye care with a personal touch.
Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, ancestry, familial status, age, physical or mental disability, pregnancy, sexual orientation, gender identity, genetic information, veteran status, or any other characteristic protected by law.
Job Type: Full-time
Pay: $41,600.00 - $52,000.00 per year
Benefits:
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
Schedule:
- Day shift
- Monday to Friday
Work setting:
- Ambulatory surgery center
- Clinic
- Medical office
- Office
- Private practice
Experience:
- ICD-10: 1 year (Preferred)
Ability to Commute:
- Lewiston, ME 04240 (Required)
Work Location: In person