Revenue Cycle Specialist

Job Description

Job Description

Position Overview - NOT A REMOTE POSITION

We are seeking 2 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.

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
• Background, OIG and Drug Screen required

Preferred Qualifications

• Experience with Modernizing Medicine - also called gGastro or ModMed (EMA) software
• Gastroenterology and/or Ambulatory Surgery Centers (ASC) billing experience

IN PERSON POSITION

Monday-Friday 8:30 am - 5:30 pm - Located in Lawrenceville GA, 1 mile from Northside Gwinnett Hospital.

Background check and Drug Screen required.

We are a Gastroenterology practice and Ambulatory Surgery Center located in Lawrenceville. Since 1996, we have dedicated ourselves to providing patients with the best quality healthcare delivered in a patient-oriented, compassionate and cost-effective manner.

Southern Gastroenterology Associates was voted Best of 2026 for Gastroenterology Healthcare in Gwinnett County!

Company Description

We are a Gastroenterology practice and Ambulatory Surgery Center located in Lawrenceville. Since 1996, we have dedicated ourselves to providing patients with the best quality healthcare delivered in a patient-oriented, compassionate and cost-effective manner.\r\n\r\nSouthern Gastroenterology Associates was voted Best of 2026 for Gastroenterology Healthcare in Gwinnett County!