Revenue Cycle Support Specialist

Advanced Orthopedic Center has been serving patients in the Southwest Florida area since 1980. Our top-notch team of physicians and surgeons - along with our support staff of physician assistants, technicians and therapists - offer comprehensive orthopedic care to patients of all ages.

In addition to treating our clinic's patients, the surgeons of Advanced Orthopedic Center serve as spring training team physicians for the Tampa Bay Rays and the Atlanta Braves major league baseball team.

Our entire staff is dedicated to providing courteous and caring service. We are currently seeking a full-time Revenue Cycle Support Specialist to join our staff.

Summary:

The Revenue Cycle Support Specialist is responsible for ensuring accurate and timely claim submission, payment posting, denial resolution, and account follow-up. This role works closely with internal departments and insurance carriers to resolve billing issues and maximize reimbursement while maintaining compliance with payer and regulatory requirements.

Key Responsibilities

• Submit accurate and timely claims to insurance carriers.
• Review and resolve claim rejections, failed claims and denials.
• Perform insurance follow-up on unpaid or underpaid claims.
• Submit corrected claims and appeals when appropriate.
• Review patient accounts to ensure accurate billing.
• Work assigned A/R reports and aging accounts.
• Communicate with payers to resolve billing discrepancies.
• Maintain detailed documentation in the practice management system.
• Identify trends in denials or payer issues and escalate when necessary.
• Assist with payment reconciliation when needed.
• Assists with patient billing and payment issues.
• Assists with electronic or paper payment posting.

Daily Duties

• Reviews and submits accurate claims.
• Work assigned claim edits and rejections.
• Follow up on outstanding insurance balances.
• Submit appeals and corrected claims.
• Review explanation of benefits (EOBs) for discrepancies.
• Update account notes and claim status.
• Assist with payer communications.
• Work aging reports and denial queues.
• Other duties as assigned by supervisor or manager.

Professional Standards

• Always maintain professional demeaner.
• Demonstrate compassion and respect for patients.
• Work collaboratively with physicians, staff, vendors, and outside facilities.
• Uphold strict confidentiality (HIPAA compliance).

Qualifications

Required:

• 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 always maintain confidentiality and professionalism.

Preferred:

• Minimum of two (2) 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.

Core Competencies

• Strong analytical and problem-solving skills.
• Knowledge of insurance billing and reimbursement processes.
• Ability to work A/R and denial queues efficiently.

• Familiarity with reviewing payer guidelines

• Attention to detail and accuracy.
• Strong communication skills.