Revenue Cycle Billing Specialist

New Life Medicine•Johnson City, TN

3d•Onsite

About The Position

The Revenue Cycle Billing Specialist is responsible for the accurate, timely, and compliant preparation, submission, and management of medical claims to insurance payers. This position plays a critical role in optimizing revenue cycle performance by ensuring services are appropriately documented, charges are accurately captured, claims are submitted promptly, and billing errors are proactively identified and resolved. The ideal candidate demonstrates strong attention to detail, knowledge of medical billing practices, and a results-oriented approach to maximizing clean claim submissions while minimizing avoidable denials and reimbursement delays.

Requirements

High school diploma or equivalent required
Minimum 2 years of medical billing or physician-practice revenue cycle experience preferred.
Working knowledge of CPT, ICD-10-CM, HCPCS, insurance billing requirements, and medical terminology.
Experience with electronic health record and practice management systems; Athenahealth experience preferred.
Familiarity with Medicare, Medicaid, and commercial insurance billing.
Proficiency with Microsoft Excel and standard office applications.
Strong organizational, analytical, and problem-solving skills.

Nice To Haves

Associate degree preferred.
Certified Professional Biller (CPB) or Certified Professional Coder (CPC).
Experience in a multispecialty or multi-location physician practice.
Familiarity with clearinghouse workflows, payer portals, and claim-editing tools.

Responsibilities

Review patient encounters to ensure charges are accurately captured and submitted.
Verify patient demographics, insurance coverage, eligibility, and billing information.
Review CPT, HCPCS, ICD-10-CM codes, modifiers, and applicable payer billing requirements for accuracy, escalating clinical coding questions as appropriate.
Prepare and submit electronic and paper claims in accordance with established timelines.
Monitor clearinghouse submissions, claim acknowledgments, and rejections.
Correct and resubmit rejected claims promptly.
Ensure timely filing requirements are consistently met.
Identify missing charges, incomplete documentation, coding discrepancies, and billing errors.
Coordinate with providers, clinical personnel, and administrative teams to resolve documentation or charge entry issues.
Monitor unbilled encounters and claims pending submission.
Maintain awareness of Medicare, Medicaid, and commercial payer billing guidelines.
Assist in identifying recurring billing issues and opportunities for process improvement.
Collaborate with collections specialists to resolve claim defects and prevent recurring denials.
Support the development of standardized billing workflows and quality control processes.
Maintain accurate documentation of billing activities and claim corrections.
Escalate systemic billing issues or payer-related concerns to RCM leadership.