Eye Health America, LLC - Revenue Cycle Specialist

Eye Health America, LLC - Revenue Cycle Specialist In order to use this site, it is necessary to enable JavaScript. Here are the instructions how to enable JavaScript in your web browser. All Jobs  >  Revenue Cycle Specialist Eye Health America, LLC Apply Revenue Cycle Specialist REMOTE WORKER - N/A Type Full-time Description Position Summary The Revenue Cycle Specialist is responsible for optimizing revenue and ensuring the accuracy and compliance of all billing and coding practices within a healthcare organization. This role involves analyzing and auditing claims, providing education and training to staff, and implementing processes to enhance revenue integrity. Essential Functions and Responsibilities - Review and audit claims, medical records, and documentation to identify errors, discrepancies, or compliance issues. - Verify that services provided are correctly documented, coded, and billed according to payer and regulatory requirements. - Work to maximize revenue by identifying opportunities for additional billable services, coding accuracy, and reducing claim denials. - Analyze reimbursement rates and fee schedules to ensure the organization is being reimbursed appropriately. - Provide training and education to clinical and administrative staff on coding and documentation best practices. - Stay updated on changes in coding and billing guidelines and share this information with relevant staff. - Monitor compliance with healthcare regulations, including CMS (Centers for Medicare & Medicaid Services) and third-party payer requirements. - Ensure that all billing and coding practices align with regulatory standards. - Analyze data and prepare reports on key performance indicators related to revenue integrity, such as coding accuracy, claim denial rates, and reimbursement trends. - Identify and implement process improvements to enhance revenue integrity, streamline workflows, and reduce errors. - Collaborate with relevant departments to resolve issues and enhance revenue cycle processes. - Assist coders and clinical staff with complex coding scenarios and documentation requirements. - Conduct regular chart reviews and provide feedback to improve documentation quality. Requirements - Bachelor's degree in a related field, such as healthcare administration, health information management, or nursing. Relevant certifications (e.g., Certified Professional Coder - CPC) may be preferred. - Several years of experience in healthcare billing, coding, or revenue cycle management, with a focus on revenue integrity. Apply View All Jobs Powered by Payroll & HR Software