Revenue Cycle Support Specialist

Advanced Orthopedic Center•Port Charlotte, FL

16d

About The Position

The Revenue Cycle Support Specialist ensures accurate and timely claim submission, payment posting, denial resolution, and account follow-up. The role works with internal departments and insurance carriers to resolve billing issues and maximize reimbursement while maintaining compliance with payer and regulatory requirements. The specialist also supports patient billing and payment issues, payment reconciliation, and electronic or paper payment posting as needed.

Requirements

High school diploma or equivalent.
Strong knowledge of medical billing and collections processes.
Understanding of Medicare, Medicaid, Workers' Compensation, and other state and federal billing regulations.
Excellent organizational skills and attention to detail.
Strong verbal and written communication skills.
Ability to maintain confidentiality and professionalism.
Strong analytical and problem-solving skills.
Knowledge of insurance billing and reimbursement processes.
Ability to work accounts receivable and denial queues efficiently.
Familiarity with reviewing payer guidelines.

Nice To Haves

At least two years of medical office experience in billing and collections.
Previous medical coding experience.
Orthopedic practice experience.
Experience with electronic medical records (EHR) and electronic claims transmission systems.

Responsibilities

Submit accurate and timely claims to insurance carriers.
Review and resolve claim rejections, failed claims, and denials.
Follow up with insurers on unpaid or underpaid claims.
Submit corrected claims and appeals when appropriate.
Review patient accounts to ensure accurate billing.
Work assigned accounts receivable reports, aging accounts, claim edits, rejections, and denial queues.
Communicate with payers to resolve billing discrepancies and assist with payer communications.
Review explanations of benefits for discrepancies.
Maintain detailed documentation and update account notes and claim status in the practice management system.
Identify trends in denials or payer issues and escalate them when necessary.
Assist with payment reconciliation, patient billing and payment issues, and electronic or paper payment posting.
Perform other duties as assigned by a supervisor or manager.
Maintain professional conduct, demonstrate compassion and respect for patients, collaborate with physicians, staff, vendors, and outside facilities, and uphold HIPAA confidentiality.