Revenue Cycle Specialist Position Available In South Central Connecticut Planning Region, Connecticut

Revenue Cycle Specialist Connecticut Retina Consultants LLC New Haven, CT 06519 • Hybrid work Job Overview Must be a Certified Coder to apply. The Certified Coder / Revenue Integrity Specialist ensures accurate and compliant coding, billing, and documentation practices for a multi-site retina specialty group. This role supports optimized reimbursement, minimized denials, and alignment with payer guidelines, while acting as a key liaison between clinical teams, billing, and compliance functions.

Key Responsibilities:

Coding & Documentation:

Review clinical documentation and assign appropriate CPT, HCPCS, and ICD-10 codes for office visits, diagnostic testing, imaging (e.g., OCT, FA), and surgical procedures (e.g., intravitreal injections, lasers, vitrectomies). Ensure proper modifier usage and global period adherence specific to retina procedures. Audit provider documentation for accuracy and completeness; provide feedback and training as needed.

Revenue Integrity:

Monitor coding patterns to ensure compliance with federal and commercial payer regulations. Identify and correct coding and billing discrepancies, working proactively to reduce denials and rejections. Collaborate with billing and clinical teams to resolve coding-related claim issues promptly.

Compliance & Education:

Stay up to date on coding changes, CMS regulations, and payer policies relevant to ophthalmology and retina care. Educate physicians, scribes, and technicians on proper documentation and coding protocols. Participate in internal audits and external reviews, preparing documentation and follow-ups as required.

Reporting & Analysis:

Track denial trends and underpayments related to coding; propose process improvements. Assist with revenue cycle metrics, coding accuracy KPIs, and compliance dashboards.

Qualifications:

Certified Professional Coder (CPC), Certified Ophthalmology Coder (COC), or equivalent certification required. Minimum 3 years of coding experience in ophthalmology; retina specialty experience strongly preferred. Deep knowledge of Medicare and commercial payer rules, with special emphasis on retina-specific billing (e.g., anti-VEGF injections, imaging bundling rules). Experience with EHR and practice management systems; familiarity with ModMed EMA or similar retina-focused platforms a plus. Strong understanding of medical necessity documentation, NCCI edits, and LCD policies.

Skills & Attributes:

High attention to detail and analytical thinking. Strong communication skills for provider education and cross-functional teamwork. Ability to manage multiple tasks and meet deadlines in a fast-paced environment. Commitment to ethical coding and compliance standards.

Job Type:

Full-time Pay:

$55,880.12 – $75,253.48 per year

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance

Schedule:

8 hour shift Monday to

Friday Work Location:

Hybrid remote in New Haven, CT 06519