What are the responsibilities and job description for the Revenue Cycle Specialist position at Southern Gastroenterology Associates?
Position Overview - NOT A REMOTE POSITION
We are seeking a highly skilled and detail-oriented Revenue Cycle Specialist with comprehensive, hands-on experience across the full medical billing lifecycle. This role requires demonstrated expertise in charge entry review, clean claims submission, payment posting, insurance verification, claims and appeals management along with a strong understanding of how each function contributes to overall revenue integrity and performance. This position is in-person only. We do not have any Remote positions.
The ideal candidate will possess in-depth knowledge of insurance guidelines, CPT and ICD-10 coding standards, reimbursement methodologies, and end-to-end revenue cycle operations, with the ability to proactively identify issues, ensure timely and accurate claim processing, and drive resolution of billing and reimbursement discrepancies. This position plays a key role in optimizing financial outcomes while maintaining compliance with all regulatory and payer requirements.
Key Responsibilities
- Perform accurate and timely charge entry review and ensure proper documentation supports all billed services
- Submit clean claims in a timely manner, ensuring compliance with CPT, ICD-10, and payer-specific billing guidelines
- Complete payment posting (EOBs/ERAs) with a high level of accuracy, identifying discrepancies, denials, and underpayments
- Conduct insurance verification to confirm eligibility, benefits (as needed)
- Manage accounts receivable (A/R) by working aging reports and performing consistent claims follow-up with payers
- Prepare and submit appeals and reconsiderations, including gathering and reviewing medical records and supporting documentation
- Investigate and resolve denials, rejections, and payer issues, ensuring timely rebilling and reimbursement
- Analyze payer trends, underpayments, and recurring issues; recommend process improvements
- Ensure compliance with Medicare, Medicaid, and commercial payer guidelines, as well as HIPAA regulations
- Collaborate with providers, front office, and clinical staff to resolve billing and documentation issues
- Perform routine billing audits to ensure accuracy in coding and reimbursement
Required Qualifications
- Minimum 3 years of medical billing/revenue cycle experience
- Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment
- Strong analytical, problem-solving, and communication skills
- Ambulatory Surgery Centers (ASC) billing experience
Preferred Qualifications
- Experience with Modernizing Medicine - also called gGastro or ModMed (EMA) software
- Gastroenterology billing experience
IN PERSON POSITION - WE DO NOT HAVE ANY REMOTE BILLING POSITIONS.
Monday-Friday 8:30 am - 5:30 pm - Located in Lawrenceville GA, 1 mile from Northside Gwinnett Hospital. Background check and Drug Screen required.
Pay: $20.00 - $24.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Application Question(s):
- This is an in-person position, will you be able to reliably commute to Lawrenceville, GA 30046 for this job, Monday - Friday 8:30 am - 5:30 pm?
Work Location: In person
Salary : $20 - $24