Revenue Cycle Billing Specialist

New Life Medicine, PLLC; North Johnson City (TN); Sur place; USD 42 000 - 60 000; Plein temps

Avantages offerts par ce poste

Medical

Dental

Vision

PTO

401k

Weekends off

Résumé du poste

New Life Medicine, PLLC in Johnson City, TN seeks a Revenue Cycle Billing Specialist to manage accurate claim submission and payer communications. You will review encounters, verify demographics and coverage, and ensure timely filing while minimizing denials.

The role requires knowledge of CPT/HCPCS/ICD-10-CM codes, experience with Athenahealth or similar EHR/PM systems, and strong Excel skills. You will collaborate with clinical and administrative teams to improve workflows and optimize revenue

Qualifications

• High school diploma or equivalent required.
• Associate degree preferred.
• Working knowledge of CPT, ICD-10-CM, HCPCS and payer requirements.
• Proficiency with Microsoft Excel and office applications.
• Experience with EHR and practice management systems, Athenahealth preferred.

Responsabilités

• Review patient encounters to ensure charges are captured and submitted.
• Verify demographics, coverage, eligibility, and billing information.
• Review CPT/HCPCS/ICD-10-CM codes and payer requirements for accuracy.
• Prepare and submit electronic and paper claims on time.
• Monitor submissions, rejections, and claim acknowledgments; resubmit as needed.
• Coordinate with providers and administrative teams to resolve documentation issues.

Connaissances

Medical billing

CPT/HCPCS/ICD-10-CM

Attention to detail

Analytical skills

Communication with providers

Problem-solving

Formation

High School Diploma

Associate degree preferred

Outils

Athenahealth

Practice management software

Description du poste

Revenue Cycle Billing Specialist

Department: Revenue Cycle Management (RCM) Reports To: Revenue Cycle Manager Employment Classification: Full-Time | Non-Exempt Location: Johnson City, TN (on-site)

Position Summary

The Revenue Cycle Billing Specialist is responsible for the accurate, timely, and compliant preparation, submission, and management of medical claims to insurance payers. This position plays a critical role in optimizing revenue cycle performance by ensuring services are appropriately documented, charges are accurately captured, claims are submitted promptly, and billing errors are proactively identified and resolved.

The ideal candidate demonstrates strong attention to detail, knowledge of medical billing practices, and a results-oriented approach to maximizing clean claim submissions while minimizing avoidable denials and reimbursement delays.

Essential Duties and Responsibilities

Claims Processing and Submission

• Review patient encounters to ensure charges are accurately captured and submitted.
• Verify patient demographics, insurance coverage, eligibility, and billing information.
• Review CPT, HCPCS, ICD-10-CM codes, modifiers, and applicable payer billing requirements for accuracy, escalating clinical coding questions as appropriate.
• Prepare and submit electronic and paper claims in accordance with established timelines.
• Monitor clearinghouse submissions, claim acknowledgments, and rejections.
• Correct and resubmit rejected claims promptly.
• Ensure timely filing requirements are consistently met.

Billing Accuracy and Quality Assurance

• Identify missing charges, incomplete documentation, coding discrepancies, and billing errors.
• Coordinate with providers, clinical personnel, and administrative teams to resolve documentation or charge entry issues.
• Monitor unbilled encounters and claims pending submission.
• Maintain awareness of Medicare, Medicaid, and commercial payer billing guidelines.
• Assist in identifying recurring billing issues and opportunities for process improvement.

Revenue Cycle Coordination

• Collaborate with collections specialists to resolve claim defects and prevent recurring denials.
• Support the development of standardized billing workflows and quality control processes.
• Maintain accurate documentation of billing activities and claim corrections.
• Escalate systemic billing issues or payer-related concerns to RCM leadership.

Required Qualifications

• High school diploma or equivalent required; associate degree preferred.
• Minimum 2 years of medical billing or physician-practice revenue cycle experience preferred.
• Working knowledge of CPT, ICD-10-CM, HCPCS, insurance billing requirements, and medical terminology.
• Experience with electronic health record and practice management systems; Athenahealth experience preferred.
• Familiarity with Medicare, Medicaid, and commercial insurance billing.
• Proficiency with Microsoft Excel and standard office applications.
• Strong organizational, analytical, and problem-solving skills.

Preferred Qualifications

• Certified Professional Biller (CPB) or Certified Professional Coder (CPC).
• Experience in a multispecialty or multi-location physician practice.
• Familiarity with clearinghouse workflows, payer portals, and claim-editing tools.

Performance Expectations

The Billing Specialist is expected to maintain consistent daily productivity, manage assigned billing queues, proactively resolve submission barriers, and ensure that claims are processed accurately and efficiently.

Success in this position is measured by the quality, timeliness, and completeness of billing activities and the reduction of preventable revenue cycle delays.

Benefits:

Medical, Dental, Vision, PTO, 401k, and Weekends off!