Revenue Cycle Specialist

District Partners is engaged with a well-established healthcare organization in the Gaithersburg, MD area to identify an experienced Hospital Insurance Follow-Up Specialist to support its revenue cycle operations.

This role is best suited for someone who understands how to work aged hospital A/R, investigate payment delays and denials, communicate effectively with insurance carriers, and determine the appropriate action needed to move an account forward. The successful candidate will be comfortable reviewing complex account histories, identifying the underlying issue, and following through until the balance is appropriately resolved.

Candidates should bring prior hospital or healthcare revenue cycle experience, strong payer follow-up skills, and the ability to manage a large account inventory with accuracy and consistency. Experience with Epic is strongly preferred.

What You'll Be Owning:

• Manage assigned insurance receivables and proactively work outstanding balances toward payment or final resolution
• Research unpaid, partially paid, and denied hospital claims to determine the cause of the outstanding balance
• Communicate with commercial, Medicare, Medicaid, and managed care payers through phone, web portals, and other available channels
• Analyze account history, remittance details, denial information, prior correspondence, and supporting documentation
• Resolve issues involving denials, eligibility, authorization, coordination of benefits, medical necessity, timely filing, billing errors, coding concerns, and underpayments
• Prepare and submit corrected claims, reconsiderations, appeals, or supporting documentation when appropriate
• Identify accounts that require escalation or additional review from coding, billing, clinical, or other internal teams
• Maintain thorough and accurate documentation of all research, payer interactions, actions taken, and required follow-up
• Monitor assigned accounts through completion and ensure appropriate next steps are taken within expected timelines
• Prioritize workload effectively while meeting established productivity, quality, and accuracy standards
• Maintain confidentiality of patient and financial information in accordance with HIPAA and organizational requirements

What You'll Bring to the Table:

• At least 2 years of experience in healthcare insurance follow-up, hospital billing, accounts receivable, or revenue cycle operations
• Prior experience managing aged insurance receivables and outstanding claim balances
• Strong knowledge of insurance follow-up, claim adjudication, denials, reimbursement, and payer processes
• Experience researching and resolving unpaid or denied claims with insurance carriers
• Ability to independently review account information and determine the appropriate course of action
• Familiarity with EOBs, ERAs, claim status responses, payer correspondence, and denial information
• Working knowledge of medical terminology and common healthcare billing concepts
• Strong analytical, investigative, and problem-solving skills
• Excellent attention to detail and documentation practices
• Ability to work effectively in a high-volume environment and manage competing priorities
• Strong verbal and written communication skills