From Home R1 Rcm Medical Coding Jobs in Riverview, FL

ABOUT SIGHTVIEW

Sightview Software LLC provides a suite of industry-leading software specifically geared toward ophthalmology and optometry practices — practice management, surgical, revenue cycle management (RCM), MIPS reporting, and more. Sightview is a one-stop shop for eye care specialists and their patients.

Integrity • Collaboration • Accountability • Resilience • Engagement

JOB SUMMARY

We are a specialized eyecare billing organization serving ophthalmology practices, optometry practices, optical shops, and ambulatory surgery centers (ASCs). We're looking for an RCM Supervisor to lead a team of billing and coding professionals, own day-to-day revenue cycle performance across our client base, and turn claim and denial data into concrete process improvements.  This is a hands-on leadership role. You'll spend part of your time coaching and developing your team and part of it in the data — identifying trends, diagnosing root causes, and driving the changes that improve first-pass yield, reduce denials, and accelerate cash. The right person combines deep eyecare coding expertise with the analytical instinct to see where the money is getting stuck and the leadership presence to fix it.

ESSENTIAL DUTIES & RESPONSIBILITIES

Team leadership & supervision

• Supervise, coach, and develop a team of billers, coders, and RCM specialists, including workload distribution, performance management, and professional development.
• Set clear productivity and quality standards,monitor againstthem, and hold the team accountable through regular feedback and structured reviews.
• Onboard and train new team members on eyecare-specific coding, payer rules, and internal workflows.

Revenue cycle operations

• Own end-to-end revenue cycle performance across assigned clients — charge capture, coding, claim submission, payment posting, denials, and A/R follow-up.
• Overseeaccurate, compliant coding for ophthalmology, optometry, and ASC facility/professional claims, including proper use of modifiers (e.g., -RT/-LT, -50, -24, -25, -79), global surgical periods, and anti-VEGF and other drug (J-code) billing.
• Manage the interplay between medical and vision benefits, including coordination of benefits and vision plan connectivity (e.g., VSP, EyeMed).
• Monitor clearinghouse activity, rejections, and payer edits; resolve issues and prevent recurrence.

Data analysis & performance improvement

• Analyze KPIs — first-pass acceptance, denial rate, days in A/R, net collection rate, clean-claim rate — toidentifytrends and problem areas.
• Diagnose root causes of denials and underpayments and lead corrective action, whether that's front-end edits, coding education, or payer escalation.
• Translate data insights into prioritized action plans and track their impact over time.

Reporting & communication

• Prepare and present performance reports and recommendations to leadership and, whereappropriate, to clients.
• Communicate clearly and proactively with internal teams, providers, and payers.
• Document andmaintainstandard operating procedures to ensure consistency and scalability.

Compliance & change leadership

• Ensure billing and coding practicescomply withpayer requirements, CMS guidelines, and applicable regulations.
• Drive processchangeand adoption of best practices across the team, championing improvements rather than simplymaintainingthe status quo.

REQUIRED QUALIFICATIONS

• Active professional coding certification (e.g., CPC, COC, or OCS/OCSR — Ophthalmic Coding Specialist).
• 5+ years of revenue cycle / medical billing experience, with direct eyecare billing experience (ophthalmology and/or optometry).
• Prior experience supervising or leading a billing/coding team.
• Working knowledge of EMR and practice management (PM) systems and the revenue cycle workflows they support.
• Strong understanding of eyecare-specific billing complexity: modifiers, global periods, drug/J-code billing, ASC facility billing, and medical vs. vision benefit coordination.
• Demonstrated analytical ability — comfortable working with claim, denial, and A/R data and acting on what it reveals.
• Excellent organizational skills and strong written and verbal communication, including the ability topresent toleadership.

PREFERRED QUALIFICATIONS

• Experience with ASC billing in addition to professional/office claims.
• Familiarity with clearinghouses (e.g., TriZetto, Waystar) and payer portals.
• Experience with specialty ophthalmology/optometry EHR and PM platforms.
• Additionalcredentials such as CPMA (auditing) or specialty ophthalmology coding certifications.
• Experience managing performance across multiple client practices or locations.