Revenue Cycle Specialist | Full-Time

Wills Eye Hospital•Philadelphia, PA

5d•Onsite

About The Position

Wills Eye Hospital is hiring a Revenue Cycle Specialist in Philadelphia, PA. In this role, you’ll be responsible for providing top-notch billing services while ensuring accuracy and efficiency in managing inpatient claims. This is a Full-Time 40 Hours per week opportunity for someone who wants to use problem-solving and healthcare knowledge to directly impact the organization’s financial performance while becoming an expert in the complex revenue cycle and insurance process. In this role, you’ll support patients, clinical departments, and the Business Office by ensuring claims are accurate, submitted timely, and reimbursed appropriately. You’ll manage the end-to-end resolution of assigned medical claims and patient accounts, with a focus on getting claims paid accurately and on time. You’ll be successful if you enjoy working in a fast-paced clinical environment, have strong attention to detail, and value patient interaction.

Requirements

High school diploma or GED required.
1-2 years of healthcare revenue cycle experience within a Hospital setting required.
Knowledge of medical terminology such as CPT, HCPCS, APC, ASC, DRG and ICD10.
Strong proficiency in Microsoft Excel.
Ability to communicate clearly (both written and verbal).
Knowledge of State and Federal healthcare guidelines and regulations.
Demonstrated experience with reviewing outstanding balances to resolution (Medicare, Medicaid, and Commercial payors).
Exceptional time management and organizational skills.
Ability to direct work with minimal supervision and ability to meet performance and quality goals.

Nice To Haves

Bachelor's degree preferred.
Associate or Industry Certification is a plus.
Demonstrated understanding of healthcare terminology, insurance plans and contract language preferred.
Experience working with Epic or other related EHR preferred.

Responsibilities

Prepares and submits billing data and medical claims to insurance companies, ensuring accurate coding.
Ensure the patient’s medical information is accurate and up to date.
Report trends in denied claims or payment discrepancies to Business Office management.
Accurately bills inpatient medical claims within established timelines and initiates dialog with payors, patients and departments.
Reviews billing documents as assigned for submission to insurance plans and government entities (Medicare, Medicaid, Tricare etc).
Clearing all edits necessary for clean claim submission.
Understands payor contracts and can apply calculations to resolve under/overpayments.
Other duties assigned.