Revenue Cycle Specialist

Unified Women's Healthcare • Boca Raton, FL

7d

About The Position

The Revenue Cycle Specialist resolves claim issues, including accounts receivable denials, payment variances, and other unresolved matters raised by internal and external customers. The role requires consistent, clear communication and collaboration with multiple internal and external parties to resolve issues. Responsibilities include reviewing and appealing denied claims, investigating payment discrepancies and payer reimbursement issues, communicating claim denials and payer trends, quality-reviewing third-party work, and generating reports as needed.

Requirements

• High school diploma or equivalent.
• At least 2 years of current experience interpreting insurance explanations of benefits, patient benefit plans, policy coverage, and patient responsibility.
• At least 2 years of current experience with medical claims, billing and collections, and appeals.
• Experience working with healthcare practice management systems.
• Experience working with cloud-based customer relationship management (CRM) technology.
• Experience with Microsoft Office and proficiency with Microsoft Excel.
• Excellent verbal and written communication skills with internal and external customers.
• Ability to collaborate effectively in a cross-functional team environment.
• Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals, including billing guidelines and policy updates.
• Working knowledge of medical billing and coding.

Nice To Haves

• Post-secondary degree preferred.
• OB/GYN specialty experience preferred.
• Athenanet experience preferred.
• Salesforce experience preferred.
• Medical billing and coding certification preferred.

Responsibilities

• Resolve accounts receivable and collections issues.
• Review, follow up on, and appeal denied claims according to standards.
• Determine the accuracy of insurance payments and follow up on discrepancies.
• Initiate, follow up on, and respond to payer reimbursement issues.
• Communicate with practices and payers regarding claim denials and payer trends.
• Analyze and quality-review work completed by third parties.
• Build and generate reports as needed.

Benefits

• Medical, dental, and vision plans
• Fertility benefits
• Supplemental insurance options
• Vacation and personal days
• Paid holidays
• 401(k) with employer contribution
• Flexible Spending Accounts (FSAs)
• Health Savings Accounts (HSAs)
• Short- and long-term disability
• Paid parental leave
• Basic life insurance and optional additional coverage
• Employee Assistance Program
• Commuter benefits
• Pet insurance
• Identity theft protection
• Professional development opportunities and resources

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED