Revenue Cycle Specialist (Collections focus)

Revenue Cycle Specialist – Chiropractic and Rehabilitation

Job Summary

We are seeking an experienced Revenue Cycle Specialist with a strong background in medical claims collections, specifically in MVA and Workers’ Compensation. This role centers on navigating complex claims, driving reimbursement, and managing the full collections lifecycle—from initial follow‑up to resubmissions, reconsiderations, and appeals. Success in this position requires deep familiarity with insurance adjusters, attorneys, and the nuanced processes involved in securing payment for orthopedic and pain management services.

Key Responsibilities

• Lead the end‑to‑end collections process for auto, workers’ compensation, and healthcare insurance claims.
• Conduct persistent and strategic follow‑up with insurance adjusters, case managers, and carrier representatives to resolve outstanding balances.
• Prepare and submit resubmissions, reconsiderations, and appeals with supporting documentation to maximize reimbursement.
• Review claim denials, delays, and partial payments to determine root causes and implement corrective actions.
• Work closely with attorneys and legal teams on complex or litigated claims, ensuring proper documentation and timely responses.
• Maintain detailed records of all communication, follow‑up activity, and claim status updates.
• Monitor aging reports and prioritize accounts to accelerate cash flow and reduce outstanding receivables.
• Stay current on insurance regulations, state-specific requirements, and payer policies related to orthopedic and pain management claims.
• Uphold HIPAA standards and maintain strict confidentiality of patient and claim information.

Experience & Qualifications

• Proven experience in medical collections, with a strong emphasis on auto, workers’ compensation, and commercial insurance claims.
• Demonstrated success working with adjusters, insurance carriers, and legal teams to resolve complex claims.
• Strong understanding of the claims lifecycle, including denials, appeals, reconsiderations, and documentation requirements.
• Experience managing high-volume, high-complexity accounts in a healthcare setting—orthopedics or pain management preferred.
• Ability to interpret EOBs, payment patterns, and claim correspondence to identify next steps.
• Exceptional communication, negotiation, and follow‑up skills.
• High attention to detail and the ability to manage multiple claims simultaneously.
• Familiarity with EMR/EHR systems and medical office workflows is helpful, though the primary focus is collections.

Pay: $45,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Experience:

• Medical billing: 1 year (Preferred)

Work Location: In person

Salary : $45,000 - $60,000