RCM/Contract Reimbursement Analyst

at  Eye Care Partners Career Opportunities

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com.

SUMMARY

The RCM Contract Reimbursement Analyst will be responsible for researching under paid claims and following up with the insurance company to acquire entitled payment or to coordinate with Accounts Receivable Specialists to work in tandem to receive maximum entitled insurance payment.

QUALIFICATIONS

• Excellent verbal, written, and interpersonal skills
• Knowledge of payer contracts
• Detail-oriented with strong organizational skills

EDUCATION AND/OR EXPERIENCE

• Minimum Required: HS Diploma or G.E.D.
• Minimum Required: 3-5 years of experience in accounts receivable or related RCM experience

SYSTEMS AND TECHNOLOGY

• Familiar with practice management system.
  NOTE: Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.

PHYSICAL REQUIREMENTS:

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
If you need assistance with this application, please contact (636) 227-2600
EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Please do not contact the office directly – only resumes submitted through this website will be considered

RESPONSIBILITIES

• Provide specialized technical and analytical support for revenue cycle.
• Strong analytical, investigative, interpolative and evaluative skills.
• Ability to access databases and utilize reporting tools to extract data, generate reports, perform data analysis and draft system/process improvement recommendations.
• Advises management regarding reimbursement issues. Research and identify opportunity areas for reimbursement enhancement.

DUTIES

• Review under paid claims and research reasons for underpayment.
• Initiate collection follow up of under claims with the appropriate payer.
• Research, appeal, and resolve underpayments with payers.
• Communicate under payment trending that impact revenue to leadership.
• Develops and maintains a working knowledge of payer contractual requirements.
• Develop and maintain positive working relationships with team members and payer representatives.
• Contact insurance companies to address discrepancies and ensure claims are paid at the contracted rate.