RCM Specialist

The Sunvera Group, an Ophthalmology managed service organization, is hiring a Charge Entry RCM Specialist to join the Revenue Cycle team in Bingham Farms, MI. We’re a cohesive and welcoming team looking for an experienced team member to help our growing business!

POSITION PURPOSE

Performs day-to-day billing and follow-up activities within the revenue cycle team.  

This position offers a great work-life balance with a hybrid schedule to allows 2-3 days to work from home each week with potential for full remote.

• Responsible entering charges for exams other services and assisting patients with their accounts.  Position requires accuracy, thoroughness and a good understanding of insurance procedures for referrals, copays, deductibles, allowables, CPT codes and Dx codes. 
• Work is multitasked and interrupted often. Must have the ability to communicate effectively with patients.
• Check eligibility and benefit verification.
• Review patient bills for accuracy and completeness and obtain any missing information.
• Prepare, review and transmit claims using billing software, including electronic and paper claim processing.
• Follow up on unpaid claims within standard billing cycle time frame following  prescribed methods.

High school diploma or GED required.

1-2 years experience in a health care related billing role. Ophthalmology preferred. 

1+ years of HMO/PPO, Medicare and Medicaid and other payment requirements and systems required.

1+ years of medical terminology required

Other Required Skills and Abilities

Must have good organizational and time management skills, can be self-directed, set priorities, meet deadlines and handle multiple tasks quickly and accurately.

Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.

Problem-solving skills to research and resolve discrepancies, denials, appeals and collections.