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 detect errors, discrepancies, or compliance issues.

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

• Discover opportunities for additional billable services, enhance coding accuracy, and minimize claim denials.

• Evaluate reimbursement rates and fee schedules.

• Deliver training and education to clinical and administrative personnel on best practices for coding and documentation.

• Keep track of changes in coding and billing regulations and communicate updates to the appropriate staff.

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

• Analyze data and generate reports on revenue integrity performance metrics.

• Identify and execute process enhancements to boost revenue integrity, optimize workflows, and reduce errors.

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

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

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

⛳️ Requirements

• Bachelor’s degree in a relevant field, such as healthcare administration, health information management, or nursing.

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

• Experience in eyecare is preferred.

• Relevant certifications (e.g., Certified Professional Coder - CPC) may be advantageous.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and continued education.

• Flexible work schedule and remote work options.

• Supportive and collaborative work environment.