Ophthalmology RCM & Billing Specialist

US Eye

Elizabeth City (NC)

Hybrid

USD 52,000 - 68,000

Full time

14 days+

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Benefits offered by this job

401(K) Company Match

Medical and Dental Insurance

Flexible Spending Accounts

Pet Insurance

Disability Insurance Life Insurance

Continuing Education

Paid Time Off

Job summary

US Eye is seeking a RCM Support Services Specialist to ensure accurate billing and strong financial communication with patients. The role focuses on verification of insurance, authorizations, and clear cost estimates for ophthalmology care, including retina services such as injections and surgeries.

The position requires 2–3 years in ophthalmology billing, CPT/ICD-10 proficiency, and experience with NextGen or similar EHR systems.

Qualifications

High school diploma or GED required; associate degree or medical billing certification preferred.
Minimum 2–3 years of ophthalmology or retina billing, authorizations, or RCM support.
Strong CPT/ICD-10 coding knowledge and payer policy understanding.

Responsibilities

Respond to patient billing inquiries and explain insurance benefits and out-of-pocket costs.
Review authorizations and referrals for validity; ensure financial clearance before service.
Coordinate with billing and clinical teams to resolve denials and improve cash flow.
Generate real-time cost estimates for visits, tests, and procedures.
Escalate complex issues to RCM leadership and cross-functional teams.
Document all payer communications in the EHR/billing system.