Remote Vision RCM Specialist – Ophthalmology

EyeCare Partners LLC; Wyandotte (MI); On-site; USD 52,000 - 78,000; Full time

Job summary

EyeCare Partners LLC is seeking a Revenue Cycle Management (RCM) Vision Ophthalmology Specialist to join the team. The specialist will handle billing, coding, payment posting, A/R follow-up, and insurance claim submission across EyeCare Partner Vision Practices.

As a subject matter expert, you will interpret EOBs, verify insurance payments, address denials, and communicate with patients and insurers to resolve discrepancies.

Qualifications

• 3+ years of Medical Insurance Billing experience, ophthalmology preferred.
• Familiarity with CPT and ICD-10.
• Knowledge of billing procedures and collection techniques.
• Experience with insurance claim submission and denials management.

Responsibilities

• Prepare, review, and transmit vision claims using billing software.
• Post payments into the practice management system.
• Status unpaid claims within standard billing cycle timeframe.
• Timely review/handling of insurance claim denials, exceptions, or exclusions.
• Forwards requests for medical records to appropriate internal resources.
• Addresses/corrects demographic information requested by insurance company.
• Ability to read and accurately interpret insurance Explanation of Benefits (EOB's).
• Verifying insurance payments for accuracy/compliance based on contracts to ensure correct reimbursement.
• Following up directly with insurance companies regarding payment discrepancies.
• Utilizing aging reports and workflow statuses to address any unpaid or open claims over 30, 60, 90, and 120 plus.

Skills

Communication skills

Attention to detail

Interpersonal skills

Medical terminology

Customer focus

Education

High School Diploma or GED

Medical coding credentials (CPC/RHIT/CCS/CMC)

Tools

Excel

Word

PowerPoint

Outlook

Job description

EyeCare Partners LLC is seeking a Revenue Cycle Management (RCM) Vision Ophthalmology Specialist to join the team. The specialist will handle billing, coding, payment posting, A/R follow-up, and insurance claim submission across EyeCare Partner Vision Practices.

As a subject matter expert, you will interpret EOBs, verify insurance payments, address denials, and communicate with patients and insurers to resolve discrepancies.