Claris Vision was formed in 2011, bringing together some of New England’s top eye care practices to provide the most comprehensive spectrum of vision care services available in the region. Claris Vision’s team of leading physicians are dedicated to providing the best clinical care, utilizing leading technology, and ensuring an individualized experience and high-quality care plan for each patient.
Reports To: Director of Revenue Cycle Management
FLSA Status: Non-Exempt
Position Summary
Claris Vision, LLC, is hiring an Account Receivables Specialist.
The Accounts Receivables Specialist is responsible for coordinating and performing timely, accurate insurance accounts receivable follow-up for ophthalmology, optometry, and surgical services. This role supports claim-status research, denial and underpayment resolution, appeals, payer escalation, and aging reduction. The Specialist maintains organized worklists, monitors follow-up deadlines, prepares A/R reporting, and assists with complex, high-dollar, and timely-filing-risk accounts. The position collaborates across the revenue cycle to improve cash flow, reduce revenue leakage, and ensure balances are resolved appropriately.
This is a remote based position for someone working in the Eastern Time Zone with hours from 8:00 AM – 4:00 PM.
Key Responsibilities
Insurance A/R Follow-Up & Resolution
- Perform daily insurance A/R follow-up across Medicare, Medicaid, commercial, managed care, and vision plans.
- Review aging reports, worklists, remittance advice, clearinghouse edits, and payer portals to identify unpaid, underpaid, rejected, or denied claims.
- Research high-dollar, aged, and timely-filing-risk accounts to determine the root cause and required next action.
- Complete or coordinate corrected claims, reconsiderations, appeals, medical-record submissions, and payer follow-up.
- Monitor assigned inventory and follow-up dates to ensure accounts receive timely, consistent action through final resolution.
- Document all account activity clearly, including payer responses, reference numbers, next steps, and expected completion dates.
- Confirm insurance balances are fully resolved before transferring any amount to patient responsibility or requesting a write-off.
- Escalate recurring payer, credentialing, authorization, coding, contract, or system issues that place reimbursement or timely filing at risk.
Coordination & Operational Support
- Serve as a knowledgeable resource for insurance A/R staff by helping research complex claims, payer rules, appeals, and escalation pathways.
- Coordinate payer worklists and priority queues as directed, organizing accounts by aging, dollar value, deadline, payer, and operational need.
- Track productivity, account aging, follow-up timeliness, and resolution trends and report exceptions or barriers to revenue cycle management.
- Perform routine account reviews to confirm appropriate follow-up, complete documentation, accurate adjustments, and compliance with payer deadlines.
- Assist with onboarding and training new team members and provide support on payer requirements, systems, and department procedures.
- Prepare assigned daily and weekly A/R reports and help maintain current policies, procedures, workflows, and job aids.
Revenue Cycle Collaboration
- Work closely with billing, coding, payment posting, denial management, credentialing, clinical, and front-end teams to resolve claim and account issues.
- Coordinate correction of missing information, claim errors, unapplied or misapplied payments, incorrect adjustments, and unresolved secondary claims.
- Identify payer trends, underpayments, authorization gaps, and workflow breakdowns and communicate actionable findings to revenue cycle leadership.
- Support month-end activities, special A/R projects, payer meetings, and department initiatives focused on aging reduction and cash acceleration.
Compliance & Process Improvement
- Ensure adherence to federal and state regulations, payer requirements, timely-filing and appeal limits, HIPAA standards, and internal policies.
- Monitor denial, aging, and reimbursement trends to identify root causes and opportunities for workflow improvement.
- Participate in system upgrades, automation testing, payer portal changes, and special revenue cycle projects.
- Escalate material compliance concerns, recurring processing failures, and revenue risks promptly to revenue cycle management.
Required Qualifications
- High school diploma or equivalent required; associate's degree preferred.
- Minimum 2-3 years of medical insurance A/R follow-up experience, preferably in ophthalmology, optometry, or surgical specialties.
- Demonstrated experience resolving denials, underpayments, claim rejections, payer requests, and timely-filing issues.
- Working knowledge of claim forms, EOBs and ERAs, adjustment and denial codes, payer portals, appeals, and medical billing workflows.
- Strong analytical, organizational, communication, and documentation skills with the ability to manage high-volume, deadline-driven work.
- Demonstrated ability to organize worklists, communicate priorities, assist peers, and support team workflows.
- Must possess the physical, mental, and cognitive skills needed to complete essential tasks, including learning, remembering, focusing, categorizing, integrating information, problem-solving, and making timely decisions.
Preferred Qualifications
- Knowledge of ophthalmology-specific reimbursement, including diagnostic testing, injections, surgeries, global periods, drugs, and implants.
- Familiarity with professional, ASC, and hospital-based A/R workflows and Medicare, Medicaid, commercial, and vision payer requirements.
- Experience with ophthalmology EHR, practice management, clearinghouse, and payer systems (e.g., iMedicWare, Medics Elite, EyeMD, or similar).
- CPC, CPB, CRCR, or another relevant billing or revenue cycle certification is preferred.
Physical & Work Requirements
- Prolonged periods of sitting and computer use.
- Ability to manage confidential patient and financial information.
- On-site, hybrid, or remote work environment based on organizational needs.
We are committed to a policy of non-discrimination and equal employment opportunity. All patients, employees, applicants, and other constituents of our clinical groups will be treated with respect and dignity regardless of race, national origin, gender, age, religion, disability, veteran status, marital/domestic partner status, parental status, sexual orientation, and gender identity and/or expression, other dimensions of diversity or common human decency. We value diversity in thought and culture and welcome highly skilled, capable, competent, collegial members to our team.