Revenue Cycle Specialist

ANDREWS INSTITUTE ASC LLC • Gulf Breeze, FL

101d

About The Position

The Revenue Cycle Specialist (RCM Specialist) serves as the central point of coordination for all revenue cycle activities at Andrews ASC, ensuring timely, accurate, and compliant billing and collections. This role bridges clinical, administrative, and financial workflows to support efficient claim lifecycle management—from scheduling through payment. The ideal candidate brings knowledge of ASC billing, strong attention to detail, and a proactive, team-centered mindset.

Requirements

• Minimum 3 years of experience in medical billing, claims follow-up, or RCM coordination (ASC experience strongly preferred).
• Familiarity with CMS guidelines, commercial payer requirements, and industry best practices.
• Proficient in Microsoft Excel, Outlook, and claims management platforms.
• Strong verbal and written communication skills.

Nice To Haves

• Bachelor’s degree in Business Administration, Healthcare Management, or related field.
• Certified Professional Biller (CPB), Certified Revenue Cycle Representative (CRCR), or CPC certification.
• Experience with surgical coding or charge entry for orthopedics, spine, or pain management procedures.
• Understanding of ASC-specific reimbursement models and payment structures.

Responsibilities

• Coordinate charge capture, coding integrity, and claim submission processes.
• Monitor clearinghouse rejections and manage timely resolution of claim edits.
• Review and maintain accurate claim aging, payment status, and denial trends.
• Investigate and resolve claim denials in collaboration with billing vendors and payers.
• Escalate recurring issues and identify payer or documentation trends that impact reimbursement.
• Maintain accurate records of appeals, follow-up efforts, and outcomes.
• Collaborate with Scheduling and Clinical teams to ensure proper insurance verifications and prior authorizations are in place.
• Track surgical authorizations and identify missing documentation pre-op.
• Partner with surgeons, coders, and clinical documentation staff to ensure op notes support billed procedures.
• Support education and process improvement for front-end revenue integrity (e.g., registration, demographics, insurance entry).
• Prepare and distribute daily, weekly, and monthly revenue cycle performance reports.
• Assist in tracking KPIs including Days in A/R, Clean Claim Rate, Denial Rate, Net Collections.
• Communicate status updates and risk areas to Finance and Administrative leadership.
• Ensure compliance with federal and commercial payer rules, including modifier use and billing guidelines specific to ASCs.
• Maintain accurate and up-to-date SOPs for revenue cycle workflows.

What This Job Offers

• Job Type: Full-time
• Education Level: Bachelor's degree