Inpatient Revenue Cycle Specialist

Page Mechanical Group, Inc.; Philadelphia (Philadelphia County); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

Retirement plan

Tuition assistance

Paid time off

Employee assistance programs (EAPs)

Job summary

Wills Eye Hospital in Philadelphia, PA is seeking a Revenue Cycle Specialist to manage end-to-end inpatient claims, ensuring timely submissions and accurate reimbursements. This full-time role focuses on optimizing the organization’s revenue cycle within a fast-paced clinical environment.

You will collaborate with the Business Office and clinical departments to resolve denials, verify payer information, and maintain compliant billing practices.

Qualifications

• High school diploma or GED is required.
• 1–2 years of healthcare revenue cycle experience in a hospital setting.
• Knowledge of 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 for Medicare, Medicaid, and Commercial payors.
• Excellent time management and organizational skills.
• Ability to work with minimal supervision and meet performance goals.

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 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.

Skills

Healthcare revenue cycle

Microsoft Excel

Communication skills

Time management

Attention to detail

Regulatory knowledge

Education

High school diploma or GED

Bachelor's degree preferred

Tools

Cerner

NextGen Practice Management

Job description

Wills Eye Hospital in Philadelphia, PA is seeking a Revenue Cycle Specialist to manage end-to-end inpatient claims, ensuring timely submissions and accurate reimbursements. This full-time role focuses on optimizing the organization’s revenue cycle within a fast-paced clinical environment.

You will collaborate with the Business Office and clinical departments to resolve denials, verify payer information, and maintain compliant billing practices.