Medical A/R Specialist
About The Position
South Florida Orthopaedics & Sports Medicine is seeking an experienced Medical A/R Specialist for its Revenue Cycle team. The specialist owns assigned accounts and independently resolves outstanding balances, payer denials, and complex reimbursement issues. The role supports a growing multi-specialty orthopaedic and musculoskeletal practice serving the Treasure Coast. The position requires strong knowledge of payer requirements, denial management, appeals, and medical claim resolution. The successful candidate is analytical, persistent, detail-oriented, communicates professionally with payers and colleagues, and works independently while contributing to a collaborative team. This is a full-time, in-office position at the practice’s Stuart, Florida office. The schedule is Monday through Friday, 8:00 AM to 5:00 PM. Compensation is described as competitive, but no specific salary range is provided.
Requirements
- Demonstrated success collecting and resolving outstanding medical accounts receivable balances.
- Recent experience preparing and filing appeals with Medicare and commercial insurance payers.
- Experience using payer portals to research claim status and payment information.
- Experience with an EMR and Practice Management system.
- Ability to read, understand, and interpret EOBs and remittance advice.
- Strong computer proficiency, including Microsoft Office applications.
- Excellent written and verbal communication skills.
- Strong analytical and problem-solving abilities.
Nice To Haves
- NextGen experience.
- Orthopaedic, surgical, or specialty practice experience.
- Knowledge of CPT modifiers and medical coding concepts.
- Experience with physical therapy and occupational therapy billing and reimbursement.
- Experience handling workers’ compensation and automobile insurance claims.
- Familiarity with Medicare regulations and commercial payer reimbursement methodologies.
Responsibilities
- Investigate and resolve insurance claim denials and underpayments.
- Review and interpret EOBs, remittance advice, and payer correspondence.
- Prepare and submit appeals to Medicare, commercial insurance carriers, workers’ compensation carriers, and auto insurance payers.
- Research claim status through payer portals and other available resources.
- Identify reimbursement trends and escalate systemic issues when appropriate.
- Resubmit corrected claims and supporting documentation.
- Collaborate with coding, billing, and management teams to resolve complex reimbursement issues.
- Identify accounts that may be uncollectible and recommend resolutions.
- Maintain productivity and quality standards while managing assigned work queues.
Benefits
- Competitive compensation.
- Medical, dental, and vision insurance.
- 401(k) retirement plan.
- Paid time off and paid holidays.
- Ongoing professional development opportunities.
- Regular industry webinars and training programs.
- Modern technology and up-to-date revenue cycle tools.
- Collaborative, supportive management team.
- Long-term career growth opportunities within a stable, growing healthcare organization.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
