Revenue Cycle Specialist

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