Revenue Cycle Specialist

3 weeks ago


Tampa, United States United Surgical Partners International Inc (USPI) Full time

Position Overview: Reporting to the Client Operations Manager, the Revenue Cycle Specialist - Collector must have a strong knowledge of medical collections, accounts receivables, insurance billing and verification, denial processing, appeal submission and EOB review. This position is responsible to resolve outstanding surgical claims resulting in maximum reimbursement.

 

Responsibilities:

  • Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.
  • Manage daily work queue to prioritize high dollar claim balances.
  • Review & work incoming insurance and patient correspondence including refund requests.
  • Send appeals when appropriate or provide the requested medical documentation.
  • Ability to review medical documentation to justify medical necessity.
  • Review patient balances to ensure accuracy and follow up with patients to obtain payments.
  • Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
  • Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
  • Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD’s) for claim resolution.
  • Negotiate payment amounts for procedures with Third Party Administrators for out of network providers.
  • Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation.


Required Skills

Requirements:

  • 2+ years of ASC revenue cycle OR orthopedic collections experience.
  • Ability to read and interpret insurance explanations of benefits and managed care contracts.
  • Must communicate effectively, both verbally and in writing, with internal and external clients.
  • Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
  • Knowledge or experience working with a variety of health care insurance payers is preferred.
  • Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
  • Advantx, Vision, HST, Waystar experience preferred.
  • High School Diploma or equivalent.


Required Experience

Requirements:

  • 2+ years of ASC revenue cycle OR orthopedic collections experience.
  • Ability to read and interpret insurance explanations of benefits and managed care contracts.
  • Must communicate effectively, both verbally and in writing, with internal and external clients.
  • Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
  • Knowledge or experience working with a variety of health care insurance payers is preferred.
  • Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
  • Advantx, Vision, HST, Waystar experience preferred.
  • High School Diploma or equivalent.


  • Tampa, United States NSN Revenue Resources Full time

    Job Type Full-time Description Company Overview: At NSN Revenue Resources, a part of USPI (United Surgical Partners International), we are the largest Ambulatory Surgery Center network in the United States. We foster a culture of innovation, collaboration, and excellence. Our Central Billing Office plays a crucial role in supporting our extensive network of...


  • Tampa, United States NSN Revenue Resources Full time

    Job Type Full-time Description 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. What we do: Full Revenue Cycle...


  • Tampa, United States The Tampa General Hospital Foundation Inc Full time

    This position reports directly to the Revenue Cycle Manager at USF Tampa General Physicians (USFTGP) in a role that has several distinct functions. The Finance and Revenue Cycle Program Specialist will drive strategic process improvement, manage complex projects, and solve difficult problems. The Finance and Revenue Cycle Program Specialist will demonstrate...


  • Tampa, United States Today's Dental Network Full time

    **JOB SUMMARY**: The position of AR Specialist plays a pivotal role within our Revenue Cycle Management team. Daily responsibilities involve managing billing and collections for both outstanding insurance claims and patient balances. This role encompasses oversight of various crucial tasks including Demographics, Coding, Charge Entry, Payment Applications,...


  • Tampa, United States NA Full time

    Job Description We are hiring Revenue Cycle Specialists who excel in Medicare Collections for our Revenue Operations Department. Specialists in this role will contact Medicare Administrative Contractors (MACs) to reconcile outstanding accounts receivable (debit balances), research and resolve problem accounts, and request adjustments or rebills on...


  • Tampa, United States SNI Companies Full time

    Job Description We are hiring Revenue Cycle Specialists who excel in Medicare Collections for our Revenue Operations Department. Specialists in this role will contact Medicare Administrative Contractors (MACs) to reconcile outstanding accounts receivable (debit balances), research and resolve problem accounts, and request adjustments or rebills on claims. ...


  • Tampa, United States Bluestone Physician Services Full time

    Bluestone Physician Services unique, robust model of care goes beyond primary care services. Our model is tailored to patients living with multiple chronic conditions and disabilities. Bluestone recognizes that patients need a customized approach to care that is preventative, proactive and includes all members of the care team. Medical providers, nurses and...


  • Tampa, United States Bluestone Physician Services Full time

    Job DescriptionJob DescriptionBluestone Physician Services’ unique, robust model of care goes beyond primary care services. Our model is tailored to patients living with multiple chronic conditions and disabilities. Bluestone recognizes that patients need a customized approach to care that is preventative, proactive and includes all members of the care...


  • Tampa, United States Bluestone Physician Services Full time

    Bluestone Physician Services unique, robust model of care goes beyond primary care services. Our model is tailored to patients living with multiple chronic conditions and disabilities. Bluestone recognizes that patients need a customized approach to care that is preventative, proactive and includes all members of the care team. Medical providers, nurses and...


  • Tampa, United States Tampa General Hospital Full time

    Job Description Description The Senior Director of Revenue Cycle Operations plays a key role in setting the strategic vision and long-term planning, aligning with organizational goals and best practice performance based on industry standards ensuringprofitability. Responsibilities & Duties ·...


  • Tampa, United States The Tampa General Hospital Foundation Inc Full time

    Job Overview: The Senior Director of Revenue Cycle Operations plays a key role in setting the strategic vision and long-term planning, aligning with organizational goals and best practice performance based on industry standards ensuring profitability. Responsibilities & Duties * Responsible for oversight and leadership of the activities and functions for...


  • Tampa, United States USF Health Full time

    Job Overview: The Senior Director of Revenue Cycle Operations plays a key role in setting the strategic vision and long-term planning, aligning with organizational goals and best practice performance based on industry standards ensuring profitability. Responsibilities & DutiesResponsible for oversight and leadership of the activities and functions for USFTGP...


  • Tampa, FL, United States, 33603 Surgery Partners Full time

    We are growing… come grow with us!   Are you looking to join a company that values their employees and offers opportunities for career growth? Surgery Partners Shared Service Center is looking for motivated employees to join their team remotely! Competitive pay and full benefits offered, as well as comprehensive training to ensure success. Surgery...


  • Tampa, United States Bekins Moving Solutions Full time

    Job DescriptionJob DescriptionCome build your career and a future with BMS Moving & Storage, one of the largest and most respected moving and storage companies in America! We are currently hiring a Revenue Accounting Specialist.Job Responsibilities:Daily input of branch revenue in our accounting systemCollection on past due invoices or returned checksWeekly...

  • Denial Specialist

    3 weeks ago


    Tampa, United States NA Full time

    Job Description The Denials Specialist performs advanced-level work related to clinical and coding denial management and appeals follow-up. The individual is responsible for conducting a comprehensive review of the insurance denial and working with the Clinical Denials Nurses and Coding Denials Specialists to compile appropriate documentation and...

  • Denial Specialist

    1 month ago


    Tampa, United States SNI Companies Full time

    Job Description The Denials Specialist performs advanced-level work related to clinical and coding denial management and appeals follow-up. The individual is responsible for conducting a comprehensive review of the insurance denial and working with the Clinical Denials Nurses and Coding Denials Specialists to compile appropriate documentation and...

  • Denial Specialist

    1 month ago


    Tampa, United States SNI Companies Full time

    Job Description The Denials Specialist performs advanced-level work related to clinical and coding denial management and appeals follow-up. The individual is responsible for conducting a comprehensive review of the insurance denial and working with the Clinical Denials Nurses and Coding Denials Specialists to compile appropriate documentation and medical...


  • Tampa, United States Tampa General Hospital Full time

    Job Summary Under the guidance of the Sr. Director of Corporate Compliance & Privacy (or designee), the Sr. Provider Coding Compliance Education Specialist ("Specialist") is an independent self-directed individual who is responsible for creating, updating, revising, and implementing the Coding and Compliance Education Program for the providers (Physician and...

  • Retention Specialist

    3 weeks ago


    Tampa, United States The LaSalle Group Full time

    LaSalle Network is actively seeking Retention Specialists for one of our clients in the Tampa, Florida area! In this position, you will help customers who are calling to cancel/change their membership and any answer inquiries they may have. Retention Specialist Responsibilities: Answer incoming calls from customers who want to cancel their accounts ...


  • Tampa, United States The LaSalle Group Full time

    LaSalle Network is actively seeking Retention Specialists for one of our clients in the Tampa, Florida area! In this position, you will help customers who are calling to cancel/change their membership and any answer inquiries they may have. Retention Specialist Responsibilities: Answer incoming calls from customers who want to cancel their accounts ...