Revenue Cycle Billing Specialist
About the job
- A high school diploma or equivalent is required.
- One year of previous healthcare billing experience in a hospital, professional, or medical office setting is required.
- Working knowledge of Microsoft Office and Excel is required.
- Experience using electronic medical record software is required.
- The ability to work independently and in team settings is required.
- Submit primary and secondary claims to payers according to insurance requirements.
- Analyze claims for billing errors throughout all stages of submission and maintain current knowledge of payer requirements.
- Work closely with appropriate staff and departments to correct issues and ensure billing accuracy, including coding edits and demographic information.
- Resolve Return to Provider claim errors in the Medicare Fiscal Intermediary Shared System daily, for hospital billing.
- Resolve New Jersey Discharge Data Collection System MIDS errors routinely as defined by management, for hospital billing.
- Verify covered hospital days and services to be rendered before submitting claims, and correct or escalate daily claim rejections in a timely manner.
- Review hospital billing reports, including late charge and 72-hour reports, and make needed corrections to ensure final bills are accurate and timely.
- Review patient accounts to determine whether third-party payments were received, recorded, and match contractual expectations; examine the account and related demographic, service, and insurance documentation.
- Follow up with payers, review claims on payer portals, make relevant manual account adjustments or financial-class changes, and respond to payer inquiries with appropriate account documentation.
- Identify and communicate payment variances, error trends, account issues, and denial trends to management for resolution.
- Review credit balances and make assigned adjustments, refunds, or claim adjustment submissions.
- Research and retrieve documentation, such as authorizations and medical records, to appeal denials.
- Process correspondence escalated by the correspondence team and communicate denials and other issues to appropriate Revenue Cycle departments or physician representatives to address root causes.
- Document clear and concise notes in the billing system and use relevant software to complete billing and follow-up tasks.
- Enter charges into the billing system from reports where relevant, and complete assigned worklists and duties accurately and efficiently.
- Maintain assigned productivity standards and escalate obstacles to meeting expectations in a timely manner.
- Prioritize and update files and required documentation according to established policies, guidelines, and procedures.
- Complete special assignments and projects with minimal supervision and meet targets.
- Adapt to changing departmental demands and perform other duties as assigned.
- Cerner, Athena, or Epic experience is preferred.
About the company
Capital Health delivers comprehensive health care across two hospitals (Regional Medical Center in Trenton and Capital Health Medical Center – Hopewell), an outpatient facility in Hamilton, and a network of primary and specialty care practices. It uses a combination of advanced technology and highly trained physicians, nurses, and staff to provide patient care. Its care model integrates inpatient, outpatient, and community services to diagnose and treat patients with efficient coordination. Distinguished by Magnet nursing excellence (three-time designation) and Joint Commission accreditation, Capital Health differentiates itself by investing in clinical staff, expanding its regional footprint, and leveraging technology to support high-quality care. The goal is to provide accessible, high-quality health services for the region while maintaining nursing excellence and accreditation.
Company Size
N/A
Company Stage
Grant
Total Funding
$1M
Headquarters
Trenton, New Jersey
Founded
N/A
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Simplify's Take
What believers are saying
- Merck’s five-year CORE grant funds Trenton cardiac access through 2031.
- Hospital at Home launched August 12, 2026, easing inpatient bottlenecks immediately.
- Hamilton heart, Princeton OB/GYN, and MFM openings expand referral capture across 2026.
What critics are saying
- The 2026 $4.5 million breach settlement keeps Capital Health’s cyber history visible.
- Capital Health still treats 503,071 breach victims’ data exposure as a live trust wound.
- Oxford Valley’s 2028 opening delays revenue while Trinity and Jefferson defend Bucks County.
What makes Capital Health unique
- Capital Health owns Mercer County’s only Level III NICU at Hopewell.
- Its Hospital at Home model shifts acute care into patients’ houses.
- Oxford Valley micro-hospital brings 24/7 emergency and inpatient care to Bucks County.
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Benefits
Health Insurance
401(k) Retirement Plan
Paid Vacation
Paid Sick Leave
Paid Holidays
Hybrid Work Options
Wellness Program
Company News
Capital Health recognized by AMA for physician well-being and reducing burnout. Capital Health has been recognized by the American Medical Association as a Joy in Medicine organization for 2026 due to its efforts supporting physician well-being and reducing burnout. Leaders at Capital Health say this distinction reflects ongoing commitments amid ongoing industry challenges. Yesterday, 7:19 a.m. Wednesday, Oct 7 By K. G. Fuentes Capital Health has earned recognition from the American Medical Association as a Joy in Medicine organization for 2026. The acknowledgment honors health systems, hospitals, and medical groups that prioritize methods to reduce burnout and enhance the professional fulfillment of doctors through patient care. "While burnout rates are declining for U.S. physicians, they still remain high when compared to other U.S. workers," said Dr. Tara VanHise, a family medicine physician at Capital Health Primary Care - Ewing and medical director of Capital Health's THRIVE Clinician Wellness Program. "Being named a Joy in Medicine organization affirms our commitment to ensuring Capital Health doctors receive the support they need to successfully navigate the administrative challenges, staffing shortages, and stigma around mental health that they face every day." The American Medical Association's Joy in Medicine Health System Recognition Program has recognized more than 250 organizations across the country since its inception in 2019. Organizations meeting its criteria are considered leaders in efforts to transform healthcare work systems and address root causes of burnout among care teams. Capital Health's THRIVE program is described as a committee of clinical leaders who represent clinicians within the organization. The program serves as a resource, working with administration to improve clinician well-being through both individual and organizational strategies. "Supporting physician well-being helps create better care for everyone," said Willie Underwood III, MD, MSc, MPH, president of the American Medical Association. "Studies show that when physicians are supported, patients benefit from safer care, higher quality, and a better overall experience. Organizations recognized by the Joy in Medicine Program are leading the way by investing in workplaces that support physicians and help them deliver compassionate, high-quality care. The AMA is proud to honor these leaders for their commitment to physician well-being and healthier communities."
Capital Health named 2026 Wellbeing First Champion for supporting health workers' mental health access. Capital Health has been named a 2026 Wellbeing First Champion by ALL IN: Wellbeing First for Healthcare in recognition of its support for staff seeking confidential mental health care. The honor highlights changes made by Capital Health to remove stigmatizing questions from credentialing applications. 7h ago Tuesday, Oct 6 By K. G. Fuentes Capital Health has been recognized as a 2026 Wellbeing First Champion by ALL IN: Wellbeing First for Healthcare, part of the Dr. Lorna Breen Foundation, according to an Oct. 6 announcement. The recognition is given to organizations that have verified their credentialing applications are free from intrusive and stigmatizing mental health questions, allowing clinicians and staff to seek mental health care or treatment for substance use without fear of losing their job. "Like everyone, health workers deserve the right to pursue mental health care confidentially," said Dr. Tara VanHise, a family medicine physician at Capital Health Primary Care - Ewing and medical director of Capital Health's THRIVE Clinician Wellness Program. "Removing overly invasive mental health questions from our licensing and credentialing applications advances the culture in health care and ensures that health care workers at Capital Health know their mental health and well-being are priorities for our organization." The THRIVE program at Capital Health is a committee composed of clinical leaders who work with administration to improve clinician well-being through both individual and organizational strategies. The program aims to provide transparent, inclusive, and safe resources for clinicians. Corey Feist, CEO and co-founder of the Dr. Lorna Breen Foundation - which leads the ALL IN: Wellbeing First for Healthcare coalition - said, "Every health worker is a human being who carries the immense weight of caring for others. For too long, our caregivers have suffered in silence, fearing that seeking the confidential mental health care they need would cost them the career they love. Capital Health is breaking that silence - sending a powerful, compassionate message to their workforce that your life matters as much as your livelihood, and you never have to choose between the two." ALL IN: Wellbeing First for Healthcare includes national organizations such as the American Hospital Association, American Medical Association, American College of Surgeons, American College of Emergency Physicians, and American Nurses Credentialing Center among its coalition members. Capital Health serves Central New Jersey/Lower Bucks County with two hospitals - the Regional Medical Center in Trenton and Medical Center - Hopewell - a Hamilton outpatient facility, and a network of primary and specialty practices across the region. The organization appears on Forbes' list of America's Best Employers for New Grads 2026.
Capital Health named to Forbes America's Best Employers for New Grads 2026 list. Capital Health has been named among Forbes' Best Employers for New Grads 2026 following an extensive national survey conducted with Statista. The organization credits this recognition to its inclusive workplace culture and various training programs designed for early-career professionals. Yesterday, 9:45 a.m. Wednesday, Sept 30 By D. G. Morgan Capital Health has been awarded a place on the Forbes list of America's Best Employers for New Grads 2026, according to a Sep. 30 announcement. The recognition is presented in collaboration with Statista and highlights Capital Health's focus on supporting recent graduates as they begin their careers. "We are incredibly proud to be recognized by Forbes as one of the best employers in the United States for new graduates," said Audra Farish, Chief Human Resources Officer at Capital Health. "This accomplishment is a reflection of our culture - one that values integrity, excellence, compassion, and teamwork. New graduates bring fresh perspectives, and we're committed to creating an environment where they can succeed and lead." Organizations included on the Forbes list were identified through an independent survey of more than 100,000 U.S. young professionals who have less than ten years of work experience and are employed by companies with at least 1,000 employees in the United States. Over two million employer evaluations were considered in total. Final scores combined personal evaluations from employees themselves with public evaluations from friends, family members of employees, or industry peers. The inclusion affirms Capital Health's commitment to building opportunities for emerging leaders and innovators within its workforce. The organization has developed policies supporting fairness and inclusivity alongside ongoing training programs designed to empower all staff members. Capital Health offers a Graduate Medical Education Program featuring residency tracks in emergency medicine, family medicine, internal medicine, OB/GYN, psychiatry, and transitional year programs. Additional residency opportunities exist in nursing and pharmacy fields through its School of Nursing - Regional Medical Center and School of Radiologic Technology - East Trenton locations. In recent years, Capital Health established internship academies preparing candidates for roles such as central sterile processing technicians, EEG technicians, emergency medical technicians, home health aides, surgical technologists, and revenue cycle operations professionals. A new summer internship program also allows current college students hands-on experience across clinical and non-clinical roles.
Capital Health begins construction of first micro-hospital in Bucks County. Thursday, September 10, 2026 To help meet the growing demand for more robust health care services in Bucks County, Capital Health has begun construction of Capital Health - Oxford Valley, the first micro-hospital in Bucks County. Micro-hospitals are an emerging option in health care, with fully accredited facilities that are smaller than full-service hospitals but more comprehensive than urgent care centers or standalone emergency rooms. Micro-hospitals like Capital Health - Oxford Valley provide inpatient and emergency care 24/7 with services designed to meet the needs of their home communities. Conveniently located near the Oxford Valley Mall, the new facility at 280 Middletown Boulevard in Langhorne, Pennsylvania will offer a range of services to nearby communities, including an emergency department, diagnostic procedures and services, and some inpatient beds for short-stay, low-acuity patients. Capital Health - Oxford Valley is expected to open in early 2028. "Our acceptance by the Bucks County community and the demand for more services is what drove our vision for the Capital Health - Oxford Valley. With Capital Health outpatient practices in Yardley, Newtown, Richboro, Levittown, New Hope, Langhorne, and Washington Crossing, we see this micro-hospital at Oxford Valley as a convenient and essential facility for our growing patient population in Pennsylvania," said Al Maghazehe, president and CEO of Capital Health. "When completed, this micro-hospital will offer diagnostic services, emergency care, and inpatient beds for short-stay, low-acuity patients, creating another access point for health care in the region. In addition to bolstering our already robust medical offerings in the area, the new micro-hospital will create close to 200 jobs and provide meaningful economic stimulus representing a $60 million investment. We look forward to welcoming patients through the doors of this new Oxford Valley location in 2028." "Today is an exciting day for Capital Health and for the communities we serve. Kicking off this construction project for our Oxford Valley location is an important milestone," said Samuel J. Plumeri, Jr., Chairman, Board of Trustees, Capital Healthcare Inc. "This project is the result of years of planning, collaboration, and a shared belief that health care should be accessible, convenient, and responsive to the needs of our growing region." Situated on seven acres adjacent to the Oxford Valley Mall and a growing residential complex, Capital Health - Oxford Valley will cover 53,000 square feet with 18 emergency department treatment bays, 10 inpatient rooms, four procedure rooms, and diagnostic imaging to include MRI, CT scans, and mammography. Among the non-surgical diagnostic and medical procedures that will be offered when the site is fully developed are upper endoscopy, colonoscopy, bronchoscopy, urological procedures, diagnostic and therapeutic injections, vascular access and interventions, and pain management procedures. Capital Health is the Central New Jersey/Lower Bucks County region's leader in providing progressive, quality patient care with significant investments in physicians, nurses, and staff, as well as advanced technology. Comprised of two hospitals (Capital Health Regional Medical Center in Trenton and Capital Health Medical Center - Hopewell), a Hamilton outpatient facility, and an extensive network of primary and specialty care practices across the region, Capital Health is a dynamic health care resource accredited by DNV. To learn more, visit capitalhealth.org.
Kim Watson joins NJ PACE Association Board. The New Jersey PACE Association is pleased to welcome Kim Watson the newly appointed Executive Director of Capital Health LIFE, to the Board. Ms. Watson is a registered nurse and previously served as director of operations for Capital Health's Institute for Urban Care (IUC). During her 21 years of service at Capital Health, Kim has shared her experience in critical care and program development. She is also certified in trauma care. Kim has successfully designed, developed, and implemented programs focusing on three key areas: chronic disease, maternal and child health, and behavioral health/substance use. With a strong background in operational management, strategic planning, and community engagement, Kim has played a critical role in enhancing the health and well-being of the Trenton community. Over her tenure, Kim has served on numerous committees, including the Advisory Board of the New Jersey Cohort Advisory Committee and the Mercer County Advisory Board for the Reduction of Gun Violence. Kim completed her undergraduate studies at Post University in Waterbury, Connecticut, where she also received her master's degree with a specialization in nursing management and organizational leadership. She received an associate degree in liberal arts and sciences from Mercer County Community College in Trenton, New Jersey and a Diploma of Nursing from Capital Health School of Nursing, also in Trenton. About NJ PACE. The NJ PACE Association The New Jersey PACE Association was established in 2018 as a 501(c)(6) nonprofit organization to promote the common interests of Programs of All-Inclusive Care for the Elderly in New Jersey, to further education for those involved in PACE, to advance the development of PACE in New Jersey and to advocate for the PACE model of care. NJ PACE Assoc is dedicated to supporting access to and advocating for the Program of All-Inclusive Care for the Elderly (PACE) with the aim of promoting independence and quality of life for older adults in their communities.