US Eye
JOB TITLE
About US Eye:
US Eye is a physician‑led, patient‑centric network of eye care practices committed to providing exceptional patient service through premium technology and unrivaled provider expertise. We are one of the nation’s leading multi‑specialty physician groups providing patients with care in ophthalmology, optometry, dermatology, and facial surgery. With 50 clinics and five surgery centers, led by 95 providers and more than 1,000 team members system‑wide, we deliver world‑class care to patients throughout Florida, the Carolinas, and Virginia.
JOB SUMMARY The
RCM Support Services Specialist
is responsible for ensuring a seamless and transparent financial experience for patients while maintaining accuracy throughout the revenue cycle. This role supports the billing and clinical teams by addressing patient billing inquiries, reviewing and updating claims, identifying charge posting or payment errors, reviewing authorizations, and performing financial clearance for upcoming procedures. The specialist also provides real‑time cost estimates for office visits, diagnostic testing, and surgeries. The ideal candidate will have a strong understanding of ophthalmology and retina billing, payer authorization requirements, and a dedication to patient‑centered financial communication.
ESSENTIAL JOB FUNCTIONS Patient Financial Support
Respond promptly and professionally to patient billing and statement inquiries while on‑site or by phone.
Clearly explain insurance benefits, copayments, deductibles, and out‑of‑pocket costs related to ophthalmology and retina services (e.g., OCT, fluorescein angiography, intravitreal injections, cataract or retina surgeries).
Patient education regarding billing/statement questions.
Assist patients with payment options, including financial assistance options, and understand their financial responsibilities.
Escalate/triage to Financial Clearance Teams when applicable.
Coordinate with the appropriate RCM Support teams for resolution of any billing issues & monitor the timely completion of those requests.
Claims and Payment Management
Research, update, and correct claim data to ensure timely and accurate submission.
Identify and resolve charge posting or payment errors, including misapplied payments, incorrect adjustments, and missing transactions.
Collaborate with billing and coding teams to correct denials or rejections and prevent recurrence.
Escalate/triage to Accounts Receivables (A/R), Charge Posting, and Payment Posting Teams when applicable.
Authorizations & Financial Clearance
Review patient accounts prior to visits, procedures, or surgeries to confirm all authorizations and referrals are valid and current.
Verify insurance eligibility and benefits for current appointments, and provide patients with detailed information pertaining to their health plan design.
Coordinate with clinical and scheduling teams to ensure all services are authorized and financially cleared before the date of service.
Escalate missing or delayed authorizations promptly to minimize denials and scheduling disruptions.
Estimates and Cost Transparency
Generate accurate, real‑time (“on‑the‑fly”) cost estimates for office visits, diagnostics, injections, and surgeries using payer information and practice fee schedules.
Triage complex or multi‑procedure estimate requests for financial counseling review and patient communication.
Workflow Efficiencies & Implementation of Enhanced Technology
Participation in a working session with other RCM team members to discuss opportunities for improvement.
Work closely with RCM senior leadership on addressing issues and implementing agreed‑upon solutions in a timely manner.
Administrative and Operational Support
Document all patient and payer communications accurately in the EHR/billing system.
Collaborate across teams—scheduling, authorizations, billing, and clinical—to ensure accurate financial data and a smooth patient experience.
Escalate complex financial or insurance issues to RCM leadership for resolution.
OTHER DUTIES AND RESPONSIBILITIES
During non‑peak times, providing additional RCM Support within other departments (i.e., patient assistance – enrollments, shipments, and replacement drugs), A/R Support (Claim status for unresponded to claims, review and outreach to patients with large outstanding balances and accounts in pre‑list status, targeted denial management).
COMPETENCIES
Expertise in insurance verification, authorization management, financial clearance and AR billing functions.
Strong analytical skills for identifying and resolving charge posting, payment errors and payer denials.
Excellent written and verbal communication with a compassionate, patient‑centered approach.
Proficiency with EHR and billing platforms (e.g., NextGen and Intellichart Pro).
Exceptional attention to detail, organization, and multitasking ability in a fast‑paced environment.
EDUCATION AND EXPERIENCE
High school diploma or GED required; associate degree or certification in medical billing preferred.
Minimum
2–3 years of experience in ophthalmology or retina billing , authorizations, or RCM support.
Strong understanding of CPT/ICD‑10 coding, payer policies, and modifier use specific to ophthalmology and retina services (e.g., injections, bilateral procedures, global periods).
POSITION TYPE AND EXPECTED HOURS OF WORK
This is a full‑time position located in University Park, Florida.
Standard business hours with occasional flexibility for pre‑surgical or month‑end workload.
Travel to other locations as necessary.
In‑office with a possible hybrid work environment during less peak times.
PHYSICAL DEMANDS
Prolonged periods of sitting at a desk and working on a computer.
The noise level in the work environment is usually moderate.
Moderate lifting 10‑50 lbs.
Hybrid role.
Ability to travel between locations as necessary.
BENEFITS
401(K) Company Match
Medical and Dental Insurance
Vision Benefits
Flexible Spending Accounts
Pet Insurance
Disability Insurance
Life Insurance
Continuing Education
Paid Time Off
#J-18808-Ljbffr
US Eye is a physician‑led, patient‑centric network of eye care practices committed to providing exceptional patient service through premium technology and unrivaled provider expertise. We are one of the nation’s leading multi‑specialty physician groups providing patients with care in ophthalmology, optometry, dermatology, and facial surgery. With 50 clinics and five surgery centers, led by 95 providers and more than 1,000 team members system‑wide, we deliver world‑class care to patients throughout Florida, the Carolinas, and Virginia.
JOB SUMMARY The
RCM Support Services Specialist
is responsible for ensuring a seamless and transparent financial experience for patients while maintaining accuracy throughout the revenue cycle. This role supports the billing and clinical teams by addressing patient billing inquiries, reviewing and updating claims, identifying charge posting or payment errors, reviewing authorizations, and performing financial clearance for upcoming procedures. The specialist also provides real‑time cost estimates for office visits, diagnostic testing, and surgeries. The ideal candidate will have a strong understanding of ophthalmology and retina billing, payer authorization requirements, and a dedication to patient‑centered financial communication.
ESSENTIAL JOB FUNCTIONS Patient Financial Support
Respond promptly and professionally to patient billing and statement inquiries while on‑site or by phone.
Clearly explain insurance benefits, copayments, deductibles, and out‑of‑pocket costs related to ophthalmology and retina services (e.g., OCT, fluorescein angiography, intravitreal injections, cataract or retina surgeries).
Patient education regarding billing/statement questions.
Assist patients with payment options, including financial assistance options, and understand their financial responsibilities.
Escalate/triage to Financial Clearance Teams when applicable.
Coordinate with the appropriate RCM Support teams for resolution of any billing issues & monitor the timely completion of those requests.
Claims and Payment Management
Research, update, and correct claim data to ensure timely and accurate submission.
Identify and resolve charge posting or payment errors, including misapplied payments, incorrect adjustments, and missing transactions.
Collaborate with billing and coding teams to correct denials or rejections and prevent recurrence.
Escalate/triage to Accounts Receivables (A/R), Charge Posting, and Payment Posting Teams when applicable.
Authorizations & Financial Clearance
Review patient accounts prior to visits, procedures, or surgeries to confirm all authorizations and referrals are valid and current.
Verify insurance eligibility and benefits for current appointments, and provide patients with detailed information pertaining to their health plan design.
Coordinate with clinical and scheduling teams to ensure all services are authorized and financially cleared before the date of service.
Escalate missing or delayed authorizations promptly to minimize denials and scheduling disruptions.
Estimates and Cost Transparency
Generate accurate, real‑time (“on‑the‑fly”) cost estimates for office visits, diagnostics, injections, and surgeries using payer information and practice fee schedules.
Triage complex or multi‑procedure estimate requests for financial counseling review and patient communication.
Workflow Efficiencies & Implementation of Enhanced Technology
Participation in a working session with other RCM team members to discuss opportunities for improvement.
Work closely with RCM senior leadership on addressing issues and implementing agreed‑upon solutions in a timely manner.
Administrative and Operational Support
Document all patient and payer communications accurately in the EHR/billing system.
Collaborate across teams—scheduling, authorizations, billing, and clinical—to ensure accurate financial data and a smooth patient experience.
Escalate complex financial or insurance issues to RCM leadership for resolution.
OTHER DUTIES AND RESPONSIBILITIES
During non‑peak times, providing additional RCM Support within other departments (i.e., patient assistance – enrollments, shipments, and replacement drugs), A/R Support (Claim status for unresponded to claims, review and outreach to patients with large outstanding balances and accounts in pre‑list status, targeted denial management).
COMPETENCIES
Expertise in insurance verification, authorization management, financial clearance and AR billing functions.
Strong analytical skills for identifying and resolving charge posting, payment errors and payer denials.
Excellent written and verbal communication with a compassionate, patient‑centered approach.
Proficiency with EHR and billing platforms (e.g., NextGen and Intellichart Pro).
Exceptional attention to detail, organization, and multitasking ability in a fast‑paced environment.
EDUCATION AND EXPERIENCE
High school diploma or GED required; associate degree or certification in medical billing preferred.
Minimum
2–3 years of experience in ophthalmology or retina billing , authorizations, or RCM support.
Strong understanding of CPT/ICD‑10 coding, payer policies, and modifier use specific to ophthalmology and retina services (e.g., injections, bilateral procedures, global periods).
POSITION TYPE AND EXPECTED HOURS OF WORK
This is a full‑time position located in University Park, Florida.
Standard business hours with occasional flexibility for pre‑surgical or month‑end workload.
Travel to other locations as necessary.
In‑office with a possible hybrid work environment during less peak times.
PHYSICAL DEMANDS
Prolonged periods of sitting at a desk and working on a computer.
The noise level in the work environment is usually moderate.
Moderate lifting 10‑50 lbs.
Hybrid role.
Ability to travel between locations as necessary.
BENEFITS
401(K) Company Match
Medical and Dental Insurance
Vision Benefits
Flexible Spending Accounts
Pet Insurance
Disability Insurance
Life Insurance
Continuing Education
Paid Time Off
#J-18808-Ljbffr