Keplr Vision

Role Description The Accounts Receivable (AR) Aging Specialist is responsible for managing and resolving outstanding insurance and patient accounts to ensure timely reimbursement and reduce aging accounts receivable. This role works directly with payers, practices, and internal teams to investigate claim issues, resolve denials, identify underpayments, and drive account resolution while maintaining productivity and quality standards. Primary Responsibilities: - AR Management - Review and work assigned AR inventory daily. - Analyze unpaid, underpaid, and denied claims. - Identify root causes of outstanding balances and take appropriate action. - Submit corrected claims, appeals, reconsiderations, and supporting documentation as needed. - Follow up with insurance carriers regarding claim status and payment delays. - Resolve patient and insurance balances within established aging guidelines. - Document all account activity accurately and thoroughly. - Denial Management - Investigate denial trends and identify opportunities for process improvement. - Research payer policies and billing guidelines. - Prepare and submit appeals within payer filing deadlines. - Escalate recurring denial issues to leadership when appropriate. - Payment Variance Resolution - Research underpayments and contractual discrepancies. - Identify payer reimbursement issues and coordinate resolution. - Monitor outstanding recoupments and refund requests. - Collaboration - Partner with Billing, Cash Posting, Patient Collections, Credentialing, and Practice Operations teams. - Participate in practice meetings and account reviews as assigned. - Communicate account issues and trends to leadership. - Quality & Compliance - Maintain compliance with payer regulations, HIPAA requirements, and company policies. - Ensure all account activity is documented accurately. - Participate in quality assurance reviews and coaching sessions. Qualifications - High School Diploma or GED required - 3-5 years of Vision medical billing, AR, collections, or denial management experience - Experience working with commercial, Medicare, Medicaid, and vision insurance preferred - Knowledge of EOBs, ERA remittances, claim appeals, and payer follow-up processes - Strong analytical and problem-solving skills - Proficient in Microsoft Office, including Excel - Excellent written and verbal communication skills Requirements - Ophthalmology or Optometry revenue cycle experience only - Multi-location healthcare experience - Experience with OfficeMate, RevolutionEHR, Eyefinity, Compulink, AcuityLogic, or similar practice management systems

Role Description The ideal candidate will work cross-functionally with internal teams, practices, and external partners to address issues, enhance operational workflows, and ensure the accurate and timely processing of insurance and patient financial transactions. This position integrates revenue cycle expertise with patient statement operations, office support, and reporting. Primary Responsibilities: - Own end-to-end patient statement workflows, including review, distribution, follow-up, and resolution of billing inquiries across 260+ practices. - Track patient statement activity, aging, and outstanding balances, ensuring accurate reporting and visibility to leadership. - Coordinate with practices, internal RCM teams, and vendors to resolve billing discrepancies and workflow issues. - Provide troubleshooting support for billing, insurance verification, and patient statement inquiries. - Manage and resolve RCM tickets in Freshservice, including documentation, follow-up, and escalation. - Navigate multiple PMS systems to extract and analyze patient AR data. - Collaborate with vendors to manage and improve statement processing and resolve escalated issues. - Maintain accurate records and ensure compliance with confidentiality standards and organizational policies. - Communicate issues, updates, and resolution timelines clearly and effectively. - Meet productivity standards and deadlines established by RCM leadership. - Support special projects and additional duties as assigned. Qualifications - Strong verbal and written communication skills. - Organized, detail oriented, comfortable with problem solving independently, technology savvy. - Experience with patient statements, billing support, or healthcare administration. - Excellent organizational and multitasking abilities. - Customer service–focused with a patient-centered approach. - Ability to work easily and cooperatively with other departments. - Ability to work independently and collaboratively in a fast-paced environment. - Ability to troubleshoot data files including but not limited to csv, xls, pdfs, txt. Requirements - Graduate of four-year high school or equivalent (GED). - 2 - 5 years: two to five years of healthcare RCM/admin experience related to the duties described. - Skills and Knowledge of EMR software functionality and operations. - Proficiency in Microsoft Office Applications.

Role Description The Claims Specialist is responsible for timely and accurate filing of all vision and medical claims for a vision care practice. This position requires working with insurance companies, creating and submitting insurance claims, processing insurance claims, and any necessary follow-up work for rejected claims. Additional responsibilities include: - Processing insurance claims and following up - Applying cash received to open invoices - Other billing departmental needs as assigned Qualifications - Good to excellent spelling, grammar and written communication skills - Knowledge and understanding of EOBs and HCFA forms - Ability to analyze and resolve unpaid claims issues - Knowledge of CPT and ICD codes - Excellent telephone and oral communication skills - Must have experience with electronic processing of medical and vision claims - Experience in Accounts Receivable (A/R) - 1-2 years of medical and vision claims experience preferred - Prior use of Practice Management and EHR Systems preferred Company Description Equal Opportunity Employer

Role Description The Cash Specialist is responsible for timely and accurate posting of all insurance payments for vision care practices. This position requires working with insurance companies, posting and reconciling insurance payments, researching payments and any necessary follow-up work required for reconciliation. - Daily posting and applying a high-volume of payments received electronically or via check - Processes necessary adjustments concurrent with Cash posting and Zero balance or Zero paid remittances - Investigates and resolves posting errors/issues and unapplied cash - Supports collection efforts - Works in conjunction with Shared Services, Practices and Field Operations Qualifications - Proper spelling, grammar and written communication skills - Knowledge and understanding of EOBs and HCFA forms - Knowledge of CPT and ICD codes - Excellent telephone and oral communication skills - Experience in Accounts Receivable - 1-2 years of medical and vision experience preferred - Prior use of Practice Management and EHR Systems preferred Benefits - Competitive salary - 401K - Generous PTO plan

Role Description The Equipment Services Manager oversees the operational support, lifecycle management, and strategic planning of clinical equipment across 260+ retail optometry locations. This role serves as the primary liaison between clinics, vendors, service providers, and leadership to ensure equipment reliability, preventive maintenance compliance, and minimal disruption to patient care. The position is responsible for managing equipment performance, coordinating repairs and replacements, supporting clinic expansion projects, and driving scalable processes related to inventory, vendor management, and capital planning. This role requires strong technical knowledge, operational leadership, and the ability to balance day-to-day clinic support with long-term strategic initiatives. - Oversee equipment support and service coordination for 260+ clinic locations - Serve as the primary escalation point for equipment repairs, troubleshooting, and replacement planning - Manage equipment lifecycle activities including warranties, preventive maintenance schedules, and inventory tracking - Analyze service trends and costs to support strategic “repair vs. replace” decisions for high-value diagnostic equipment - Partner with leadership on budgeting, quotes, purchasing guidance, and capital planning initiatives - Build and maintain relationships with equipment vendors, distributors, and service providers - Coordinate with IT, Facilities, Operations, and Construction teams on remodels, relocations, and new office setups - Develop scalable processes, reporting tools, and tracking systems using Microsoft Teams and equipment management platforms - Support clinic operations by minimizing downtime and ensuring timely resolution of equipment issues Qualifications - 5+ years of experience in optometry, ophthalmology, healthcare operations, or clinical equipment management - Strong technical knowledge of optometric and ophthalmic diagnostic equipment - Experience managing projects, vendor relationships, or multi-site operational support - Strong troubleshooting, organizational, analytical, and communication skills - Proficiency with Microsoft Office, Microsoft Teams, and equipment tracking systems - Ability to work independently and effectively in a fully remote environment Benefits - Competitive compensation package including medical, dental, vision, life insurance, disability coverage, generous PTO, paid holidays, and 401(k).

Director of Revenue Cycle Management (RCM) Position Summary The Director of Revenue Cycle Management (RCM) is responsible for overseeing and optimizing all aspects of the revenue cycle for a multi-site corporate optical organization. This role ensures efficient billing, coding, collections, and reimbursement processes across professional services (optometry) and retail optical sales. The Director will lead strategic initiatives to maximize revenue, improve cash flow, ensure compliance, and enhance the patient/customer financial experience. Key Responsibilities Revenue Cycle Oversight - Direct and manage end-to-end revenue cycle operations, including patient registration, insurance verification, coding, charge capture, billing, collections, and denial management - Oversee both vision insurance (e.g., VSP, EyeMed) and medical billing processes - Ensure accurate integration of clinical services and retail optical transactions into the revenue cycle Financial Performance & Optimization - Monitor key performance indicators (KPIs) such as days in A/R, clean claim rate, denial rate, and collection ratios - Identify revenue leakage and implement corrective actions - Develop and execute strategies to improve cash flow and reduce write-offs Compliance & Risk Management - Ensure compliance with federal, state, and payer regulations (HIPAA, CMS guidelines, etc.) - Maintain up-to-date knowledge of coding requirements (ICD-10, CPT, HCPCS) relevant to optometry and optical services - Oversee internal audits and coordinate external audits as needed Team Leadership - Lead, mentor, and develop RCM staff including billing, coding, and collections teams - Establish performance goals and accountability measures - Foster a culture of continuous improvement and operational excellence Systems & Process Improvement - Evaluate and optimize practice management systems, EHR, and billing platforms - Partner with IT and operations teams to improve workflows and automation - Lead implementation of new technologies or system upgrades Cross-Functional Collaboration - Collaborate with clinical leadership, retail operations, and finance teams - Support pricing strategies, payer contract negotiations, and reimbursement modeling - Provide training and guidance to front-end staff on accurate data capture and insurance processes Qualifications Education & Experience - Bachelor’s degree in Healthcare Administration, Finance, Business, or related field (Master’s preferred) - 7–10+ years of progressive experience in revenue cycle management - 3–5+ years in a leadership role - Experience in optical, optometry, ophthalmology, or retail healthcare strongly preferred Knowledge & Skills - Deep understanding of both medical and vision insurance billing - Strong knowledge of coding (CPT, ICD-10) and payer guidelines - Proven ability to analyze financial data and drive performance improvements - Experience with practice management and EHR systems - Excellent leadership, communication, and problem-solving skills Key Competencies - Strategic thinking and execution - Financial acumen - Operational efficiency - Change management - Attention to detail and compliance focus

Position: RCM Team Lead Reports To: RCM Supervisor/Manager Classification: Exempt/Full-Time Location: Remote JOB DESCRIPTION: The Revenue Cycle Management Claims Team Lead will be responsible for all aspects of the claim cycle. This is a dual position with its own workload along with oversight to train, audit and monitor the group for accurate procedures and turnaround. Ensure workflow, including collecting payments stays current and on track with regards to insurance carriers, patients, vendors, and internal interactions. PRIMARY RESPONSIBILITIES: - Identify, analyze, and manage all issues pertaining to accounts receivable. - Coordinate, assign, audit and supervise the work of the staff assigned to ensure productivity standards and goals are consistently met. - Review and analyze past due receivables on a weekly basis. - Monitor AR reconciliations, and related adjustments to ensure accuracy and timely processing. - Establish and maintain productive relationships with key resources, including Managers. - Active participation in weekly AR calls; coordinate activities and share responsibility for projects with other key AR staff. - Establish and maintain the necessary billing and receivables updates/ tracking systems to maximize collections and cash flow. - Work with Managers to determine the level of automation possible and the necessary personnel to achieve collection goals. - Oversee monthly A/R reporting requirements. - Coach and Supervise staff including performance management, mentoring, 1-on-1 s, training needs identification and development, work- flow planning and escalate disciplinary actions to Supervisor/Manager. - Work the aging accounts and collect pending receivable payments from insurance companies. - Prioritize and effectively communicate. - Work with the team to achieve and maintain key AR benchmarks. - Meet Teams Productivity and Quality Goals. QUALIFICATIONS: - Strong decision making, problem solving, and solution finding. - Possesses the ability to work in a constantly changing environment, good judgment skills, and capable of making decisions with attention to detail. - Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency and accuracy. - Must have excellent analytical and problem-solving skills. - Ability to work easily and cooperatively with other departments. - Ability to work independently and follow through on tasks without direct supervision. - Ability to work well under pressure in a flexible and expeditious manner. - Must have experience with Microsoft Products and PMS systems, EMR systems, and clearing houses. EXPERIENCE / EDUCATIONAL REQUIREMENTS: Education: Graduate of four-year high school or equivalent (GED). Experience: - One to Two years of leading AR teams, over-all at-least 5 Years of Experience in RCM. - Previous experience in Optical/Vision is highly preferred! - Skills and Knowledge of EMR software functionality and operations. - Proficiency in Microsoft Office Applications.