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Sr. Revenue Cycle Specialist

Eye Health America

Eye Health America

Accounting & Finance
Remote
Posted on Dec 13, 2025
Job Type
Full-time
Description

The Sr. Revenue Cycle Specialist is responsible for optimizing revenue and ensuring the accuracy and compliance of all billing and coding practices within a healthcare organization. This role involves analyzing and auditing claims, providing education and training to staff, and implementing processes to enhance revenue integrity.

Essential Functions and Responsibilities

  • Review and audit claims, medical records, and documentation to identify errors, discrepancies, or compliance issues.
  • Verify that services provided are correctly documented, coded, and billed according to payer and regulatory requirements.
  • Work to maximize revenue by identifying opportunities for additional billable services, coding accuracy, and reducing claim denials.
  • Analyze reimbursement rates and fee schedules to ensure the organization is being reimbursed appropriately.
  • Provide training and education to clinical and administrative staff on coding and documentation best practices.
  • Stay updated on changes in coding and billing guidelines and share this information with relevant staff.
  • Monitor compliance with healthcare regulations, including CMS (Centers for Medicare & Medicaid Services) and third-party payer requirements.
  • Ensure that all billing and coding practices align with regulatory standards.
  • Analyze data and prepare reports on key performance indicators related to revenue integrity, such as coding accuracy, claim denial rates, and reimbursement trends.
  • Identify and implement process improvements to enhance revenue integrity, streamline workflows, and reduce errors.
  • Collaborate with relevant departments to resolve issues and enhance 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.

What We Offer:

  • Competitive compensation and performance incentives
  • Comprehensive benefits including medical, dental, vision, and 401(k)
  • Career growth opportunities within a fast-growing healthcare platform
  • A collaborative and mission-driven culture focused on delivering exceptional patient care
Requirements
  • Bachelor's degree in a related field, such as healthcare administration, health information management, or nursing. Relevant certifications (e.g., Certified Professional Coder - CPC) may be preferred.
  • Several years of experience in healthcare billing, coding, or revenue cycle management, with a focus on revenue integrity.
  • In-depth knowledge of ICD-10, CPT, HCPCS, and other coding systems.
  • Familiarity with CMS and other regulatory billing guidelines.
  • Strong analytical and problem-solving skills.
  • Effective communication and training abilities.
  • Proficiency in using healthcare information systems and coding software.