Revenue Cycle Specialist | Full-Time

Wills Eye Hospital•Philadelphia, PA

2d•Onsite

About The Position

Wills Eye Hospital is hiring a full-time Revenue Cycle Specialist in Philadelphia, Pennsylvania. This role provides billing services and manages inpatient claims and patient accounts to ensure claims are accurate, submitted on time, and reimbursed appropriately. The specialist supports patients, clinical departments, and the Business Office by resolving assigned medical claims and accounts, with a focus on accurate, timely payment. The position is based in a fast-paced clinical environment and involves patient interaction, collaboration with teams, and communication with payors, patients, and departments. Wills Eye Hospital describes itself as a nationally recognized leader in ophthalmology and vision care, with a collaborative, mission-driven clinical environment and access to advanced technology and specialized care teams.

Requirements

High school diploma or GED.
1–2 years of healthcare revenue cycle experience in a hospital setting.
Knowledge of medical terminology, including CPT, HCPCS, APC, ASC, DRG, and ICD-10.
Strong proficiency in Microsoft Excel.
Clear written and verbal communication skills.
Knowledge of state and federal healthcare guidelines and regulations.
Experience reviewing outstanding balances through resolution for Medicare, Medicaid, and commercial payors.
Strong time-management and organizational skills.
Ability to direct work with minimal supervision and meet performance and quality goals.

Nice To Haves

Bachelor’s degree preferred.
Associate degree or industry certification is a plus.
Understanding of healthcare terminology, insurance plans, and contract language preferred.
Experience with Cerner and NextGen Practice Management systems.

Responsibilities

Prepare and submit billing data and medical claims to insurance companies, ensuring accurate coding.
Ensure patients’ medical information is accurate and up to date.
Report trends in denied claims or payment discrepancies to Business Office management.
Bill inpatient medical claims accurately within established timelines and initiate dialogue with payors, patients, and departments.
Review assigned billing documents for submission to insurance plans and government entities, including Medicare, Medicaid, and Tricare.
Clear edits necessary for clean claim submission.
Understand payor contracts and apply calculations to resolve overpayments and underpayments.
Perform other duties as assigned.