RCM Specialist-Medical Biller

Company

Overview

TruVista Surgery Center in Troy, MI is a state-of-the-art ambulatory surgery center specializing in ophthalmic procedures. The facility is designed for efficiency, comfort, and innovation—offering cataract, glaucoma, and oculoplastic surgeries with the latest technology. A strong fit for candidates who value teamwork, excellence in surgical outcomes, and a modern clinical setting.

Position

Summary

Assign codes and charges; create billing statements, post payments and adjustments for all procedures performed within the facility. Perform other business office jobs as needed or assigned.

Responsibilities

• Assign procedural and diagnostic codes for all services.
• Enter these codes, along with facility charges, into the computer system.
• Create and mail insurance billings on a regular basis and accordance to facility policies.
• Create and mail patient statements on a regular basis.
• Post payments and adjustments to accounts daily,process refunds
• Review all accounts monthly for activity.
• Contact insurance companies to determine reason for nonpayment. Review, edit and rebill claims.
• Send additional information to payer and/or insured as may be requested.
• Review credit balances and submit reports to Administration.
• Generate monthly reports for Administration.
• Responsible to keep the days in AR within facility guidelines.
• Aware of and adheres to facility functions, policies and procedures.
• Participate in pertinent educational offerings and monthly meetings.
• Sort mail coming to the facility, open business office mail, create bank deposit.
• Comply with regulatory standards and practices.
• Manage and resubmit rejection notices.
• Knowledge and adherence to HIPAA guidelines.
• Perform other business office duties as assigned including but not limited to registration, reception, chart filing and insurance verification.
• Skills in organization and prioritization of assignments through to completion.
• Ability to resolve service issues and know when to escalate to Administration.
• Deliver high quality customer service to internal and external customers with integrity and compassion.
• Maintain tact and professionalism while working collections accounts.
• Research and identify discrepancies that hinder payment.
• Transcribe patient information from schedule, calculate totals and net amounts for collection.
• Ensures accurate billing with 3rd party payers and Medicare parties.
• Reports unusual occurrences and events in timely and accurate fashion and performs Process Improvements as needed.
• Maintain pleasant and positive attitude.
• Must work well with all staff, physicians, vendors, and especially peers. Willing to assist others when requested. Demonstrates cooperation and works as a team member.
• Perform other office functions as directed by Administrator/Supervisor.

Qualifications

• Must be proficient in the English language, both written and verbal.
• High school graduate or equivalent. Professional training preferred.
• Experience in submitting billings for health care - Preferred.
• Knowledge of billing and diagnostic codes used in billing for health care services -ICD-10 and CPT (Preferred).
• Knowledge of regulatory standards.
• Ability to work with MS Office and practice management software.
• Knowledge of ophthalmology billing (preferred) Company

Benefits

We offer a competitive benefits package to our employees:

• Medical
• Dental
• Vision
• 401k w/ Match
• HSA/FSA
• Telemedicine
• Generous PTO Package We also offer the following benefits for FREE:
• Employee Discounts and

Perks

• Employee Assistance Program
• Group Life/AD&D
• Short Term Disability Insurance
• Long Term Disability Insurance Truvista Surgery Center is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees #IND