Revenue Integrity Specialist — Billing & Coding

Eye Health America; Easley (SC); On-site; USD 65,000 - 90,000; Full time

Job summary

Eye Health America is seeking a Revenue Cycle Specialist to optimize revenue and ensure accurate billing and coding across the organization. The role involves auditing claims, educating staff, and implementing processes to improve revenue integrity.

You will review documentation, ensure coding and billing alignment with payer requirements, and collaborate with departments to reduce denials and improve workflows. Prior experience in eyecare and CPC certification are preferred.

Qualifications

• Bachelor’s degree in healthcare administration, health information management, or related field.
• Several years of experience in healthcare billing, coding, or revenue cycle management.
• Eyecare experience preferred.

Responsibilities

• Review and audit claims, medical records, and documentation for errors and compliance.
• Verify services are documented, coded, and billed per payer and regulatory rules.
• Identify opportunities to maximize revenue and reduce claim denials.
• Analyze reimbursement rates and fee schedules for proper reimbursement.
• Provide training on coding and documentation best practices.
• Stay updated on changes in coding and billing guidelines and share with staff.
• Monitor CMS and third-party payer compliance and ensure regulatory alignment.
• Analyze data and report metrics on revenue integrity, such as denial rates.
• Collaborate with departments to improve revenue cycle processes.
• Assist coders with complex coding scenarios and chart reviews.

Skills

Billing and coding

Auditing

Revenue integrity

Training staff

Regulatory knowledge

Education

Bachelor's degree in healthcare administration or related field

CPC certification (preferred)

Tools

Billing software

Job description

Eye Health America is seeking a Revenue Cycle Specialist to optimize revenue and ensure accurate billing and coding across the organization. The role involves auditing claims, educating staff, and implementing processes to improve revenue integrity.

You will review documentation, ensure coding and billing alignment with payer requirements, and collaborate with departments to reduce denials and improve workflows. Prior experience in eyecare and CPC certification are preferred.