Revenue Cycle Specialist
We are seeking a detail-oriented and experienced Certified Professional Coder (CPC) to join our private healthcare organization specializing in ENT (Otolaryngology), Allergy, Audiology, and Physical Therapy services.
KEY RESPONSIBILITIES
Coding & Charge Entry
- Review provider documentation and evaluate accurate CPT, HCPCS, and ICD-10-CM codes for ENT, Allergy, Audiology, and Physical Therapy services.
- Ensure coding complies with payer policies, CMS guidelines, and regulatory requirements.
- Identify missing documentation, coding discrepancies, and opportunities for claim correction.
- Maintain productivity and accuracy standards for daily charge entry and coding workflows.
- Stay current on coding updates, payer changes, and specialty-specific billing rules.
Accounts Receivable & Collections
- Manage and monitor outstanding insurance and patient balances.
- Perform monthly collection activities on delinquent accounts in accordance with company policy.
- Follow up on unpaid, denied, or underpaid claims with insurance carriers.
- Research payment variances and resolve billing issues promptly.
- Work aging reports to improve cash flow and reduce outstanding receivables.
Patient Accounts & Refunds
- Process patient refunds accurately and timely in accordance with internal controls.
- Review credit balances and determine appropriate refund or adjustment action.
- Respond professionally to patient billing inquiries by phone, email, or in person.
- Explain statements, insurance processing, balances due, and payment options.
Compliance & Administrative Support
- Maintain confidentiality of patient information in accordance with HIPAA regulations
- Assist with audits, reporting, and revenue cycle improvement initiatives.
- Collaborate with front office, clinical staff, and management to resolve account issues.
- Support special billing projects and workflow improvements as needed.
QUALIFICATIONS
Required
- Minimum 3 years of medical coding and billing experience in a physician practice or outpatient setting.
- Strong knowledge of CPT, ICD-10-CM, HCPCS, and insurance claim processing
- Proficiency with EHR/PM systems and Microsoft Office.
- Working knowledge of medical terminology, anatomy and physiology, disease processes, medical records, and healthcare procedures.
- Familiarity with claim edits, denials management, and payment posting workflows.
- Experience with accounts receivable follow-up and collections.
- Knowledge of commercial insurance, Medicare, Medicaid, and workers’ compensation billing.
- Excellent communication skills via all avenues of communication
- Strong organizational and prioritization skills with a high level of attention to detail and the ability to work independently
Preferred
- Experience in ENT/Otolaryngology and Allergy Coding
In addition to an exceptional work environment and Friday afternoons off each week, Peoria ENT offers the following benefits:
· Medical, Dental, Vision, Life Insurance
· Tuition Assistance
· Paid Vacation and Illinois Paid Leave Hours
· 401(k) and/or Roth
· Competitive, hourly rate
Job Type: Full-time
Pay: $20.00 - $25.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- medical billing or revenue cycle management: 2 years (Required)
Work Location: In person
