Medical Billing & Revenue Cycle Specialist

Providence Community Health; Warwick (RI); On-site; USD 45,000 - 65,000; Full time

Job summary

Providence Community Health in Rhode Island is seeking a Revenue Cycle Specialist to manage the financial aspects of patient care, including accurate coding (ICD-10, CPT, HCPCS), claim submission, denial resolution, and timely reimbursement. You will verify patient insurance eligibility and post payments to patient encounters.

The role requires HIPAA compliance, strong attention to detail, and effective communication with patients, providers, and payers.

Qualifications

• Proficient in CPT, HCPCS, and ICD-10 coding.
• Experience with EPIC EHR and professional billing systems.
• Ability to resolve unpaid/denied claims to ensure timely payment.
• Strong knowledge of HIPAA regulations and compliance.
• Spanish language skills preferred, not required.

Responsibilities

• Review clinical documentation to confirm diagnostic (ICD-10) and procedural (CPT/HCPCS/ADA) codes.
• Submit electronic or paper claims to payers and follow up on denials.
• Verify patient insurance eligibility and coverage.
• Post payments and adjustments to accounts; reconciliations.
• Respond to billing inquiries from patients, providers, and payers.
• Maintain HIPAA-compliant billing records and documentation.
• Document trends causing claim issues and report to management.

Skills

Medical terminology

EPIC EHR

CPT/HCPCS/ICD-10 coding

Communication skills

HIPAA compliance

Microsoft Office

Spanish language (preferred)

Education

High School diploma or equivalent

Certified Professional Coder (preferred)

Tools

EPIC EHR

Billing software

Clearinghouse

EHR systems

Job description

Providence Community Health in Rhode Island is seeking a Revenue Cycle Specialist to manage the financial aspects of patient care, including accurate coding (ICD-10, CPT, HCPCS), claim submission, denial resolution, and timely reimbursement. You will verify patient insurance eligibility and post payments to patient encounters.

The role requires HIPAA compliance, strong attention to detail, and effective communication with patients, providers, and payers.