Revenue Cycle Specialist - Surgical Claims - Remote

Overview

We are seeking an experienced and detail-oriented Accounts Receivable Specialist to join our central billing office team for ambulatory surgery centers. The successful candidate will play a crucial role in resolving outstanding surgical claims resulting in maximum reimbursement.

In Short

• Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers.
• Prioritize high dollar claim balances through work queues.
• Review & work incoming insurance and patient correspondence.
• Send appeals when appropriate or provide the requested medical documentation.
• Review patient balances to ensure accuracy and follow up with patients.
• Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
• Review insurance payments and determine accuracy of reimbursement.
• Negotiate payment amounts for procedures with Third Party Administrators.
• Recommend adjustments or refunds for overpayments.
• Leverage knowledge of Medicare and Medicaid for claim resolution.

Requirements

• 2+ years of ASC revenue cycle OR orthopedic collections experience is preferred.
• Strong understanding of medical billing and insurance reimbursement processes.
• Ability to read and interpret insurance explanations of benefits.
• Excellent interpersonal and communication skills.
• Must be able to multi-task and handle competing priorities.
• Intermediate computer proficiency in Microsoft Office.
• Advantx, Vision, HST, Waystar experience preferred.
• High School Diploma or equivalent.

Benefits

• Competitive salary and benefits package.
• Opportunities for growth and advancement within the organization.
• Passion for revenue cycle management.
• Commitment to ensuring timely and accurate payment for healthcare services.