Revenue Integrity & Billing Specialist

Eye Health America; Northern (KY); Hybrid; USD 60,000 - 86,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Short-term/Long-term Disability

Life Insurance

Matching 401(k)

Employee Discount

Wellness Program

Paid Vacation & Holidays

Uniform Allowance

Training/Advancement opportunities

Job summary

Eye Health America is seeking a Revenue Cycle Specialist to optimize revenue and ensure accurate billing and coding practices. You will audit claims, educate staff, and implement processes to improve revenue integrity across our southeastern partner practices.

The role involves identifying opportunities for additional billable services, reducing denials, and staying current with CMS and payer guidelines. Collaboration with clinical and administrative teams is essential to deliver compliant,

Qualifications

• Bachelor's degree in a related field such as healthcare administration, health information management, or nursing.
• Relevant certifications (e.g., CPC) may be preferred.

Responsibilities

• Review and audit claims, medical records, and documentation to identify errors or compliance issues.
• Verify services are documented, coded, and billed per payer and regulatory requirements.
• Maximize revenue by identifying additional billable services and reducing claim denials.
• Analyze reimbursement rates and fee schedules to ensure proper reimbursement.
• Provide training to clinical and administrative staff on coding and documentation best practices.
• Stay updated on coding and billing guidelines and share with staff.
• Monitor compliance with CMS and third-party payer requirements.
• Ensure all practices align with regulatory standards.
• Prepare reports on KPIs related to revenue integrity (coding accuracy, denial rates, trends).
• Identify and implement process improvements to enhance revenue cycle workflows.
• Collaborate with departments to resolve issues and enhance revenue cycle processes.
• Assist coders and clinical staff with complex coding scenarios.
• Conduct regular chart reviews and provide feedback to improve documentation quality.

Skills

Healthcare billing

Revenue cycle management

Coding accuracy

Education

Bachelor's in healthcare administration/health information management

Certified Professional Coder - CPC

Job description

Eye Health America is seeking a Revenue Cycle Specialist to optimize revenue and ensure accurate billing and coding practices. You will audit claims, educate staff, and implement processes to improve revenue integrity across our southeastern partner practices.

The role involves identifying opportunities for additional billable services, reducing denials, and staying current with CMS and payer guidelines. Collaboration with clinical and administrative teams is essential to deliver compliant,