Senior Revenue Cycle Specialist

USA Clinics Group•Northbrook, IL

11h•Onsite

About The Position

We are seeking a detail-oriented and analytical Senior Insurance Collections Specialist with strong expertise in revenue cycle processes. The ideal candidate will have hands-on experience in payment posting, denial management, and identifying trends in insurance reimbursements. This role requires a proactive mindset with a focus on process improvement and leveraging automation, including AI-driven solutions.

Requirements

Strong understanding of Accounts Receivable (A/R) processes in healthcare revenue cycle.
Hands-on experience with payment posting and reconciliation.
In-depth knowledge of denials management and resolution strategies.
Ability to analyze payer behavior and identify trends in insurance reimbursements.
Familiarity with EOBs, ERAs, CPT/ICD codes, and insurance guidelines.
Strong analytical and problem-solving skills.
Experience with healthcare billing systems and EHR/RCM platforms.
Proficiency in Excel and reporting tools.

Nice To Haves

Experience in automation initiatives or AI-based tools within revenue cycle management.
Knowledge of process improvement methodologies (Lean, Six Sigma, etc.).
Certification in medical billing/coding (e.g., CPC, CCS) is a plus.

Responsibilities

Perform accurate and timely payment posting for all payer types (insurance, patient, and third-party).
Manage Accounts Receivable (A/R) follow-ups to ensure timely collections and resolution of outstanding balances.
Analyze and resolve claim denials, including root cause identification and corrective actions.
Identify denial patterns and payer trends, and recommend process improvements to reduce recurring issues.
Work closely with billing, coding, and payer teams to ensure proper claim submission and reimbursement.
Monitor aging reports and prioritize accounts for follow-up.
Maintain compliance with payer guidelines and internal policies.
Document actions taken on accounts clearly and accurately in the system.
Collaborate with cross-functional teams to improve overall revenue cycle performance.
Proactively identify opportunities to streamline workflows and implement automation, including AI-based tools for denial prediction, posting accuracy, and trend analysis.