Revenue Cycle Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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👻 Ghost score 10%

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Eye Health America

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2018

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2018-03

Healthcare • Healthcare Insurance • Pharmaceuticals

Eye Health America is dedicated to providing personalized eye care services, focusing on patient-centered approaches and innovations. With a mission to improve lives through exceptional eye care, the company partners with leading eye care practices in the Southeast region, emphasizing collaboration, quality, and patient satisfaction. Eye Health America aims to grow as a trusted healthcare partner by aligning its values with those of its member practices.

📋 Description

• Review and audit claims, medical records, and documentation to identify errors, discrepancies, or compliance issues. • Verify that services are correctly documented, coded, and billed according to payer and regulatory requirements. • Identify opportunities for additional billable services, improve coding accuracy, and reduce claim denials. • Analyze reimbursement rates and fee schedules. • Provide training and education to clinical and administrative staff on coding and documentation best practices. • Monitor changes in coding and billing guidelines and share updates with relevant staff. • Monitor compliance with CMS and third-party payer requirements. • Analyze data and prepare reports on revenue integrity performance indicators. • Identify and implement process improvements to enhance revenue integrity, streamline workflows, and reduce errors. • Collaborate with relevant departments to resolve issues and improve 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. • Several years of experience in healthcare billing, coding, or revenue cycle management, with a focus on revenue integrity. • Eyecare experience preferred. • Relevant certifications (e.g., Certified Professional Coder - CPC) may be preferred.