RCM Specialist-Medical Biller

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.

Responsibilities

• Assign procedural and diagnostic codes for all services.
• Enter codes, along with facility charges, into the computer system.
• Create and mail insurance billings on a regular basis in accordance with 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.
• Keep the days in Accounts Receivable (AR) within facility guidelines.
• Adhere 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.
• Adhere to HIPAA guidelines.
• Perform other business office duties as assigned, including but not limited to registration, reception, chart filing, and insurance verification.
• Resolve service issues and escalate to Administration when necessary.
• 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.
• Ensure accurate billing with third-party payers and Medicare.
• Report unusual occurrences and events in a timely and accurate fashion and perform process improvements as needed.
• Maintain a pleasant and positive attitude.
• Work well with all staff, physicians, vendors, and peers; demonstrate cooperation and teamwork.
• Perform other office functions as directed by Administrator/Supervisor.

Requirements

• High school graduate or equivalent; professional training preferred.
• Experience in submitting billings for healthcare (preferred).
• Knowledge of billing and diagnostic codes used in healthcare services—ICD-10 and CPT (preferred).
• Knowledge of regulatory standards.
• Proficiency in MS Office and practice management software.
• Knowledge of ophthalmology billing (preferred).
• Proficient in the English language, both written and verbal.
• Strong organizational and prioritization skills.
• Ability to work well in a team environment and assist others when requested.

Benefits

• Medical, Dental, and Vision insurance
• 401k with company match
• HSA/FSA options
• Telemedicine
• Generous PTO package
• Free benefits:
  • Employee Discounts and Perks
  • Employee Assistance Program
  • Group Life/AD&D Insurance
  • Short Term Disability Insurance
  • Long Term Disability Insurance