Revenue Cycle Specialist | Full-Time - Philadelphia, PA

About the role

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.

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.

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.

Preferred Qualifications

• 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.

About Wills Eye Hospital

Wills Eye Hospital is a world-renowned leader in ophthalmology, ranked among the top eye hospitals in the nation by U.S. News & World Report. Established in 1832, Wills Eye is one of the oldest and most respected eye care institutions in the world. Each year, our team provides specialized care to more than 250,000 patients, ranging from routine eye conditions to complex, sight-threatening diseases. Through advanced surgical capabilities, innovative research, and a commitment to clinical excellence, we continue to shape the future of vision care.