Revenue Cycle and Managed Care Specialist

Job Description

Job Description

Revenue Cycle & Managed Care Specialist

Location: Edmond, OK – Onsite

Pay: $25–$35/hour, based on experience

Schedule: Monday–Friday, flexible daytime hours

Employment Type: Direct Hire

Benefits: Medical, Dental, Vision

Position Overview

Addison Group is hiring for our client, an established healthcare management organization supporting 14 Ambulatory Surgery Centers (ASCs) nationwide .

We are seeking a Revenue Cycle & Managed Care Specialist with a strong foundation in ASC/outpatient surgery reimbursement, collections, and payer follow-up . This is an excellent opportunity for someone ready to expand beyond traditional AR and gain experience in managed care, payer contracting, credentialing, enrollment, and fee schedule management.

The team is willing to train on many aspects of the position. The most important qualification is understanding how outpatient surgery claims are reimbursed and how to investigate when they don't pay correctly .

Responsibilities

• Research denied, underpaid, and incorrectly reimbursed claims
• Determine expected reimbursement using payer contracts and fee schedules
• Identify root causes of payment discrepancies and work issues through resolution
• Communicate with insurance carriers and navigate payer/provider portals
• Review payer contracts and reimbursement terms
• Assist with commercial payer, Medicare, and Medicaid enrollment
• Support credentialing and recredentialing
• Maintain payer contracts and fee schedules across multiple ASCs
• Help ensure updated fee schedules are accurately loaded into billing systems
• Assist with managed care contracting and bundled payment programs
• Troubleshoot payer and Revenue Cycle issues as they arise
• Use Excel for tracking, analysis, and operational support

Qualifications

• 2–3+ years of healthcare Revenue Cycle experience
• ASC or outpatient surgery collections/AR experience strongly preferred
• Understanding of ASC/outpatient surgery reimbursement
• Knowledge of commercial and Medicare reimbursement
• Basic understanding of CPT codes
• Experience researching denials, underpayments, and payer discrepancies
• Ability to read and understand payer contracts
• Comfortable communicating directly with insurance payers
• Strong analytical and problem-solving skills
• Ability to manage changing priorities in a fast-paced environment

Nice to Have:

• Managed care or payer contracting experience
• Credentialing/recredentialing experience
• Medicare or Medicaid enrollment experience
• Fee schedule experience
• Strong Microsoft Excel skills

What Makes Someone Successful

We are looking for someone who enjoys being a problem-solver . You should be comfortable digging into a claim, researching why it paid incorrectly, reviewing the contract, and determining what should have happened.

You should also be:

• Coachable and eager to learn
• Flexible when priorities change
• Detail-oriented and analytical
• Comfortable working independently once trained
• Interested in growing beyond traditional Revenue Cycle responsibilities

Why Consider This Opportunity?

• $25–$35/hour
• Direct-hire opportunity
• Very low employee turnover
• Strong company culture and long-term career opportunities
• Significant hands-on training and development
• Exposure to Revenue Cycle, managed care, payer contracts, credentialing, enrollment, and ASC operations
• Opportunity to work closely with senior leadership
• Potential to take on greater ownership and responsibility as you grow

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

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