Revenue Cycle Specialist

Position Summary

Under the supervision of the Revenue Cycle Supervisor, the Revenue Specialist is responsible for ensuring the timely collection of accounts receivable, monitoring account activity, and providing adequate follow‑up to maximize reimbursement for physician billing. The ideal candidate has a strong understanding of medical claims billing.

• Research and resolve claim denials using appropriate resources.
• Verify that pre‑bill claims pass internal edits in a timely fashion.
• Monitor that all denied claims are corrected or appealed.
• Collaborate with other teams within the business office.
• Provide appropriate feedback to management.

• Perform collection activities such as status calls to ensure timely reimbursement, appeals, and account review.
• Ensure appropriate information is submitted to insurance companies to expedite payment.
• Take follow‑up actions on accounts to ensure claims are paid on the first follow‑up call or appeal.
• Follow up on assigned cases from within the organization.
• Review pre‑bill claim holds to verify that the claim goes out clean the first time.
• Compose appeals to insurance carriers for denied claims.
• Handle incoming calls for information requests from insurance companies within 24 hours.
• Assist Financial Counselors when patients have questions regarding claims.
• Correct accounts that are billed to incorrect insurance companies.
• Ensure authorizations are attached to claims.
• Comply with quantity and quality expectations as provided by management.
• Communicate with the lead, supervisor, and team to advise of trends and issues discovered.
• All other duties as assigned.

• High School Diploma or GED.
• 2–4 years of physician office billing and denial management experience required.
• Basic understanding of ICD
  10, CPT, HCPCS.
• Ability to read and interpret explanation of benefits (EOBs).
• Knowledge of Medicare Part B and commercial insurance products.
• Familiar with CMS 1500.
• Basic understanding of medical terminology and anatomy.
• Athena experience strongly preferred.
• Excellent written and verbal communication skills.
• Self‑starter, detail‑oriented, and capable of multi‑tasking.
• Comprehensive knowledge of computer skills including Microsoft Office Suite.
• Comfortable in a fast‑paced working environment of a growing practice.

• Full‑time opportunities with room for career growth and advancement.
• Excellent job security and stability, promoting an optimal work‑life balance.
• Be part of a dynamic and growing high‑level Business Office team.

Florida Orthopaedic Institute is an Equal Opportunity Employer.