Medical A/R Specialist
About The Position
South Florida Orthopaedics & Sports Medicine is seeking an experienced Medical A/R Specialist to join their Revenue Cycle team. This role involves solving complex claim issues, appealing denials, and recovering revenue. The practice has been a trusted provider of orthopaedic and musculoskeletal care on the Treasure Coast since 1995, offering services in orthopaedics, sports medicine, joint replacement, pain management, physical therapy, and occupational therapy. They are looking for passionate revenue cycle professionals to maximize reimbursement and improve financial outcomes.
Requirements
- Demonstrated success collecting and resolving outstanding medical accounts receivable balances
- Recent experience preparing and filing appeals with Medicare and commercial insurance payers
- Experience utilizing payer portals to research claim status and payment information
- Experience with an EMR and Practice Management system; NextGen experience strongly preferred
- 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
- 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
- Investigating and resolving insurance claim denials and underpayments
- Reviewing and interpreting EOBs, remittance advice, and payer correspondence
- Preparing and submitting appeals to Medicare, commercial insurance carriers, workers' compensation carriers, and auto insurance payers
- Researching claim status through payer portals and other available resources
- Identifying reimbursement trends and escalating systemic issues when appropriate
- Resubmitting corrected claims and supporting documentation
- Collaborating with coding, billing, and management teams to resolve complex reimbursement issues
- Identifying accounts that may be uncollectible and making recommendations for resolution
- Maintaining 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
- A 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
