Insurance Verification | Payment Posting | Accounts Receivable Full-Time | Ambulatory Surgery Center We are looking for an experienced Revenue Cycle Management (RCM) Specialist to join our Business Office team at a busy ophthalmology ambulatory surgery center (ASC). This is a hands-on role for someone who understands the healthcare revenue cycle and takes pride in getting the details right—from insurance verification and clean claims through payment posting, AR follow-up, and denial resolution . The ideal candidate is organized, analytical, dependable, and comfortable taking ownership of their AR. If you enjoy finding out why a claim hasn't paid, identifying the issue, fixing the problem, and getting the reimbursement back where it belongs, this may be a great fit for you. What You'll Do Insurance Verification & Billing Verify insurance eligibility, benefits, and coverage for surgical services. Ensure patient and insurance information is accurate and complete. Identify eligibility, authorization, and coverage issues before they impact reimbursement. Prepare and submit accurate, timely ASC facility claims for procedures. Monitor clearinghouse activity and resolve claim rejections. Apply contractual adjustments accurately according to payer contracts and facility procedures. Understand payer requirements related to ophthalmology procedures, surgical services, and facility reimbursement. Work closely with the clinical and scheduling teams to resolve insurance and billing issues. Payment Posting Post insurance payments, EFTs, checks, and patient payments accurately and timely. Post contractual adjustments and other account transactions. Maintain accurate patient and insurance ledgers. Reconcile payment batches and identify discrepancies. Process secondary claims when appropriate. Monitor and resolve credit balances. Review payments and reimbursement to identify potential underpayments or payer issues. Accounts Receivable & Denials Work insurance and patient AR across all aging categories. Follow up on unpaid, underpaid, and delayed ophthalmology claims. Research and resolve billing, coding, payment, and reimbursement issues. Work zero-pay claims and identify recurring payer issues. Manage claim denials and submit corrected claims and appeals when appropriate. Follow up on high-dollar and complex ophthalmology claims. Monitor claims involving surgical procedures, implants, supplies, and other applicable ophthalmic services. Maintain thorough account documentation and follow-up notes. Identify AR trends and communicate issues and opportunities to management. Work proactively to reduce aging AR and improve overall reimbursement. What We're Looking For 2+ years of healthcare revenue cycle, medical billing, insurance verification, payment posting, or AR experience preferred. Strong understanding of insurance eligibility, benefits, payer requirements, and reimbursement. Experience working insurance AR, denials, appeals, and payer follow-up. Experience with payment posting and EFT reconciliation. Knowledge of Medicare and commercial payer requirements. Knowledge of medical terminology and basic coding concepts. Strong computer skills and proficiency with Microsoft Office. Experience with Waystar and/or SIS is a plus. CPC or other RCM/coding certification is a plus. Ophthalmology and/or ASC facility billing experience is a plus. The Right Person for This Role You are someone who: Pays close attention to detail and doesn't let things fall through the cracks. Can manage multiple priorities while meeting deadlines. Is comfortable working independently and taking ownership of assigned AR. Thinks critically and knows how to research and resolve payment issues. Understands that accurate insurance verification can prevent downstream billing and AR problems. Can recognize when a claim has been incorrectly paid, denied, or underpaid. Communicates professionally with patients, insurance carriers, physicians, clinical staff, and coworkers. Looks for the root cause of billing and reimbursement problems rather than simply moving an account forward. Is motivated by accuracy, accountability, and getting results. Why This Role Matters Every step of the revenue cycle impacts the financial health of our ophthalmology surgery center. This position plays an important role in making sure services are verified correctly, ophthalmology claims are submitted cleanly, payments are posted accurately, and outstanding AR is actively worked to resolution. We're looking for someone who understands that strong RCM starts before the claim is ever submitted and who takes ownership of the process from insurance verification through final reimbursement. If you have experience improving reimbursements, and being part of a team that values accuracy and accountability, we'd love to hear from you.

Pay:

$25.00 - $28.00 per hour Expected hours: 40.0 per week

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Application Question(s): Do you have experience working insurance AR, including claim denials, unpaid/underpaid claims, payer follow-up, and appeals? The ASC is open Monday through Thursday, closed Fridays. The hours for this position are 06:30AM-05:00PM, does this work for you?

Experience:

Ambulatory Surgical Center:

1 year (Preferred)

Work Location:

In person