This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a member of the Revenue Cycle Management Team, the RCM Specialist is a subject matter expert regarding RCM processes and procedures necessary for EyeCare Partner Practices. The RCM Specialist may be responsible for multiple elements including, but not limited to: - Billing - Coding - Payment Posting - Accounts Receivable (A/R) follow up - Insurance claim submission - Managing customer service requests from patients Duties and Responsibilities: - Prepare, review, and transmit claims using billing software including electronic, website submission, and paper claim processing - Post payments both electronically and manually into the practice management system according to set standards and productivity measures - Status unpaid claims within standard billing cycle timeframe - Timely review/handling of insurance claim denials, exceptions, or exclusions - Forwards requests for medical records to appropriate internal resources - Addresses/corrects demographic information requested by insurance company - Ability to read and accurately interpret insurance Explanation of Benefits (EOB’s) - Verifying insurance payments for accuracy/compliance based on contracts to ensure correct reimbursement is received - Following up directly with insurance companies regarding payment discrepancies - Utilizing aging reports and workflow statuses to address any unpaid or open claims over 30, 60, 90, and 120 plus - Coordination of Benefits (COB) – Ability to identify and bill secondary or tertiary - Documenting denials associated with patient responsibility to forward to the collection team - Ability to research and appeal denied claims - Answering all patient or insurance telephone inquiries pertaining to assigned accounts - Report payment discrepancies or denial trends identified to Supervisor as soon as they are identified for assigned accounts - Keep supervisor abreast weekly of any concerns or issues associated with accounts - Adhering to company standards of compliance with policies and procedures - Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service - Performs other duties that may be necessary or in the best interest of the organization Qualifications - High School Diploma or GED - CPC, RHIT, CCS, or CMC Coding Credentials preferred Requirements - 3+ years of Medical Insurance Billing - Ophthalmology Practice preferred Knowledge, Skills and Abilities Requirements - Experience with CPT and ICD-10; Familiarity with medical terminology - Knowledge of billing procedures and collection techniques - Strong written and verbal communication skills - Detail oriented, professional attitude, reliable consistent production results - Logical, critical thinking, and research skills - Excellent organization, time management, and prioritization skills - Professional in appearance and actions - Customer-focused with excellent written, listening and verbal communication skills - Enjoys learning new technologies and systems - Exhibits a positive attitude and is flexible in accepting work assignments and priorities - Meets attendance and tardiness expectations - Management and organizational skills to support the leadership of this function - Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations - Interpersonal skills to support customer service, functional, and teammate support need - Able to communicate effectively in English, both verbally and in writing - Intermediate computer operation proficiency with Microsoft Excel, Word, PowerPoint and Outlook - Practice management software and clearing houses experience - Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines Location/Work Environment - For on-site team members, work takes place in a normal office/clinical environment. Travel to other locations may be necessary to fulfill the essential duties and responsibilities of the job. - For remote team members, HIPAA compliant home office environment. Ability to work in a remote environment while performing required duties and remaining patient focused. - Able to work varying shifts including early mornings/evenings to attend meetings and cross training or support other initiatives.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We're looking for a Healthcare Billing Specialist with eClinicalWorks experience to join our growing team at HELM! You'd be working remotely with our client in the Orthopaedic industry in a remote capacity. In this role, you will manage the full medical billing revenue cycle within eClinicalWorks, from charge entry through payment posting, denial management, appeals, and accounts receivable follow-up, ensuring claims are submitted accurately and resolved efficiently. You will work closely with insurance payers, patients, and internal teams to maintain clean billing workflows and prevent recurring claim issues. The ideal candidate has strong hands-on experience using eClinicalWorks for billing, understands the full claim lifecycle end-to-end, is highly detail-oriented, and takes ownership of billing issues through to resolution without supervision. Responsibilities: - Manage the full revenue cycle within eClinicalWorks (eCW), from charge entry through payment. - Submit claims accurately and track them through adjudication. - Post insurance payments and adjustments into the system. - Manage denial management and appeals, identifying root causes and preventing recurrence. - Conduct insurance follow-up and accounts receivable (AR) management. - Review claim adjudication and identify errors quickly. - Communicate with insurance payers to resolve claim issues. - Answer and resolve patient billing questions professionally. - Coordinate with front desk, verification, and clinical teams as needed. - Document all billing activities clearly within eClinicalWorks. - Track and resolve claims through to payment. - Maintain clean, organized billing workflows. - Support invoicing, financial worksheets, and month-end close deliverables as needed. Qualifications - Strong hands-on experience using eClinicalWorks (eCW) for billing — required. - Demonstrated experience handling the full medical billing lifecycle. - Proven experience with charge entry, claim submission, payment posting, AR management, and denial resolution. - Ability to independently manage insurance follow-ups. - Ability to quickly identify claim errors and denial causes and implement corrective action. - Strong attention to detail and consistent documentation habits. - Clear spoken and written English. - Comfortable communicating with insurance payers and patients. - Highly organized, process-driven, and ownership-oriented. - Reliable home office setup with strong internet connection. - Available to work Eastern Time (EST) hours. - Able to start within 3 weeks (latest start date: April 1). Benefits - Remote work opportunity. - Full-time, 40 hours/week, Standard EST business hours. - Pay Range: $1,000 - $1,400/month. - BYO Devices. Company Description Helm is a staffing agency that connects A-Players with meaningful opportunities and strives for growth. If you're ready to make an impact in healthcare operations, we’d love to hear from you. Does the following describe you? - Superb written and spoken English (we assess skills unassisted by AI tools). - Entrepreneurial, attentive to others, curious, and hungry for growth. If so, let’s talk! You can learn more about Helm here , or from our founder’s YouTube podcast.

Requisition Number: 2341763 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Manager, Ambulatory Coding will manage and be accountable for professional employees and/or supervisors within ambulatory (professional fee) coding operations. The impact of work is primarily at the local level, with decisions influencing multiple groups of employees and internal and external customers. This role sets team direction, resolves problems, provides guidance to staff, and adapts departmental plans and priorities to address business and operational challenges. The manager influences forecasting and planning activities and ensures coding operations support compliant, accurate reimbursement and revenue cycle performance. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: - Manages and is accountable for professional coding staff and/or supervisors supporting ambulatory and professional fee coding - Sets team direction, establishes priorities, resolves operational and personnel issues, and provides guidance and coaching to team members - May oversee and coordinate work activities of other coding supervisors - Adapts departmental plans and priorities to address business needs, operational challenges, regulatory changes, and workload demands - Influences and provides input into forecasting, staffing models, productivity targets, and operational planning - Ensures compliance with federal, state, payer, and internal coding regulations, policies, and standards - Acts as a subject matter resource to coding staff, physicians, billing, revenue cycle, and operational partners - Leads efforts to maximize reimbursement, improve coding quality, reduce charge lag, and maintain acceptable turnaround times - Oversees coding productivity, quality audits, pended accounts, DNFC reconciliation, and related performance metrics - Uses analytics, benchmarking, and reporting to identify trends, risks, and opportunities and to make data-driven business recommendations - Leads or supports process improvement initiatives impacting ambulatory coding workflows and revenue cycle performance - Coordinates and prioritizes multiple projects and initiatives, ensuring timely completion and alignment with business objectives - Develops, motivates, and retains a competent and well-trained coding workforce through training, coaching, and performance management - Completes probationary and annual performance evaluations and supports continuing education and professional development - Collaborates with physicians, finance, IT, billing, and leadership to support operational goals and customer service excellence - Product, service, and process decisions may impact multiple groups of employees and internal and external customers - Solid leadership, communication, problem-solving, and decision-making skills You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - Active CCS or CPC coding certification - 5+ years of ambulatory/professional fee coding experience in a multi-specialty environment - 3+ years of coding leadership or supervisory experience (Team Lead experience acceptable) - Experience with electronic health records, encoders, and/or computer-assisted coding tools (e.g., Epic, 3M, EncoderPro) Preferred Qualifications: - Experience supporting Revenue Cycle performance improvement initiatives - Proven solid analytical skills with the ability to interpret and present data to leadership *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Behavioral Health Billing Specialist-Irwin, PA Achieving True Self (ATS) is seeking a Full-time Billing Specialist with experience in Behavioral Health and ABA services. Previous experience with CentralReach and Waystar is a BIG plus! $17-19 / hour commensurate with experience. This position is a remote position with the ability to be present in Irwin, PA for team meetings when necessary. ATS is currently providing services in Maryland, Pennsylvania, Virginia, and West Virginia. You will be working with a plethora of insurances and medical assistance and previous experience is needed. Excellent verbal and written communication is a must for this role. What are the benefits of working with Achieving True Self? - We offer bi-weekly, competitive pay, along with up to 2 weeks paid time off based on hours worked, six paid holidays, and family medical leave options if eligible. - We offer medical coverage from individual to family plan options, dental, vision for those who qualify. ATS covers a portion of your monthly costs for medical benefits. We also offer a Health Reimbursement Account to employees to assist with the cost of your plans deductible to those eligible. - Retirement options in the form of 401K with an employer match, as well as supplemental, voluntary insurance as well as short term disability plans for those who qualify. - Employer paid life insurance is available for eligible employees. - We offer an entirely free and confidential employee assistance program that gives you access to mental health, financial health, legal services, and wellness benefits that can be used for you and your family. This includes a discount program too, like pet insurance. - Performance reviews conducted with supervisors to foster professional development. - We “Hire to Retire” providing you with the tools necessary to grow with Achieving True Self. Tuition discounts, college and university partnerships, and continued education and supervision opportunities for those who want to go back for continued education. - We celebrate differences and thrive on diversity. We are committed to an inclusive-company culture, where team members can thrive and feel valued. What are the minimum requirements to apply for this position? - A high school diploma is required, proof will be required via diploma, transcripts, etc. - Although this position is remote, we ask that you live within a reasonable traveling distance of Irwin, PA to attend company meetings, events, team-building activities when required. - Previous experience in billing and collections, preferably one year of experience. - Experience working with Medicaid’s eligibility system. - Knowledge of Google and G Suite Applications. - Moderate comfort with adapting to new systems. - Experience with electronic / clearinghouse billing software. - Have an unstoppable passion for excellence and an unquestionable commitment to those we serve. What are the essential functions of the role of a Billing Specialist? - Enter services, adjustments, and related data into the billing system accurately and efficiently. - Electronic payor billing (835-837) claims submission, posting payments, and working denials, as well as managing AR functions. - Work collaboratively to determine billing inconsistencies, workflow discrepancies. - Ensure billing practices align with contractual requirements. - Strong attention to detail and ability to multitask. - Monitor changes in contracts and updates billing procedures to ensure compliance. - Negotiate contract rates with payors throughout the year and for new payors. - Evaluate potential to shift to value-based payments. - Use discretion and sensitivity while managing medical records and personal documentation. - Work well as a team. - HIPAA guidelines/regulations followed. - Steward the mission, vision, values and beliefs of ATS with all interactions in role. Our Mission: Achieving True Self is passionately cultivating and inspiring growth through the delivery of evidence-based treatment to assist individuals, families, organizations and their surrounding communities to achieve their self-defined goals. Through a supportive organizational culture focused on developing and retaining team members, we are determined to change the world by instilling hope and helping each person whose life we touch achieve their truest self. Achieving True Self is an equal opportunity and affirmative action employer that celebrates differences and thrives on diversity. Applicants and employees will not be discriminated against because of their race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, or factors and characteristics prohibited by local, state or federal laws. V 3/11/26 Achieving True Self is an Equal Opportunity Employer (EOE). Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law.