A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
Wills Eye Hospital is hiring a Revenue Cycle Specialist in Philadelphia, PA . 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 Why Join Wills Eye At Wills Eye Hospital, you'll be part of a nationally recognized leader in ophthalmology and vision care. We are known for clinical excellence, innovation, and patient-centered care.
We offer:
Competitive compensation and benefits such as medical, dental, and vision plans, retirement plan, tuition assistance, paid time off, and employer assistance programs (EAPs) Opportunities for training, certification, and career growth A collaborative, mission-driven clinical environment Access to advanced technology and specialized care teams In this role, you'll support patients, clinical departments, and the Business Office by ensuring claims are accurate, submitted timely, and reimbursed appropriately. You'll manage the end-to-end resolution of assigned medical claims and patient accounts, with a focus on getting claims paid accurately and on time. You'll be successful if you enjoy working in a fast-paced clinical environment, have strong attention to detail, and value patient interaction. Key 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. What You Bring You may be a strong fit for this role if you are detail-oriented, patient-focused, and comfortable in a clinical setting. You enjoy working as part of a team, communicating clearly, and supporting both patients and providers. Minimum Qualifications 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. We know great candidates do not always meet every preferred qualification. If this role interests you and you believe you could be successful in it, we encourage you to apply. You may be a fit for other roles across our organization. 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. Ready to take the next step? Apply today for our Revenue Cycle Specialist opportunity in Philadelphia, PA.
Recruitment Process Safety :
Official recruitment communications from Wills Eye will only come from an authorized @willseye.org email address. Wills Eye will never ask for payment, banking information, Social Security numbers, or other sensitive personal information during the early stages of recruitment, and we do not extend offers without a formal interview process. If you receive a suspicious message or offer, please do not click links, open attachments, or share personal information. Please note Wills Eye does not offer remote positions.