Revenue Cycle Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct reviews and audits of claims, medical records, and documentation to pinpoint errors, discrepancies, or compliance concerns.

• Ensure that the services rendered are accurately documented, coded, and billed in accordance with payer and regulatory standards.

• Spot opportunities for additional billable services, enhance coding accuracy, and decrease claim denials to optimize revenue.

• Evaluate reimbursement rates and fee schedules to guarantee suitable compensation.

• Offer coding and documentation training and education to both clinical and administrative personnel.

• Stay updated on changes in coding and billing guidelines and disseminate pertinent information to staff.

• Oversee compliance with CMS and third-party payer regulations.

• Confirm that billing and coding practices are in alignment with regulatory benchmarks.

• Analyze data and compile reports on revenue integrity KPIs, encompassing coding accuracy, claim denial rates, and reimbursement trends.

• Recognize and implement process enhancements to boost revenue integrity, streamline workflows, and minimize errors.

• Collaborate with relevant departments to address issues and refine revenue cycle processes.

• Support coders and clinical staff with intricate coding scenarios and documentation needs.

• Perform regular chart reviews and provide constructive feedback to enhance documentation quality.

⛳️ Requirements

• A bachelor's degree in a relevant field, such as healthcare administration, health information management, or nursing.

• Several years of experience in healthcare billing, coding, or revenue cycle management, emphasizing revenue integrity.

• Experience in eyecare is preferred.

• Relevant certifications, such as Certified Professional Coder (CPC), may be advantageous.

🏝️ Benefits

• Medical, Dental, Vision, Short-term Disability, Long-term Disability, Life Insurance, etc.

• Matching 401(k)

• Employee Discount

• Wellness Program

• Paid Vacation & Holidays

• Uniform Allowance

• Training/Advancement opportunities