Revenue Cycle Specialist

Avion Park | OSM 5315 Avion Park Dr Tampa, FL 33607, USA Description Position Summary: Under direct supervision of the Worker’s Comp Manager, this position is responsible for assuring timely collection of accounts receivable, monitoring account activity and providing adequate follow‑up to ensure maximum reimbursement is received for physician billing. The ideal candidate would have a strong understanding of medical claims billing. Research and resolve claims denials using the appropriate resources Check that pre‑bill claims are passing internal edits in a timely fashion Monitor that all denied claims are corrected or appealed Collaborate with other teams within the business office Provide appropriate feedback to management Key Responsibilities: Perform collection activities, such as status calls to ensure timely reimbursement, appeals and account review Ensure appropriate information is submitted to insurance companies in order to expedite payment Take appropriate follow‑up actions on accounts to ensure claims are paid on the first follow‑up call or appeal Determine that appropriate information is submitted to insurance companies in order to expedite payment Follow up on assigned cases from within the organization Review pre‑bill claim holds to verify that the claim goes out clean the first time Compose appeals to insurance carriers for denied claims Handle incoming calls for information requests from insurance companies within 24 hours Assist Financial Counselors when patients have questions regarding claims Correct accounts that are billed to incorrect insurance companies Ensure authorizations are attached to claims Comply with quantity and quality expectations as provided by management Communicate with the lead, supervisor and team to advise of trends and issues discovered Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute All other duties as assigned Qualifications: High School Diploma or general education degree (GED) 2 – 4 years of physician office billing and denial management experience required Basic understanding of ICD‑10, CPT, HCPCS Ability to read and interpret Explanation of Benefits (EOBs) 4+ years of experience with worker’s compensation and commercial insurance products Familiar with CMS 1500 Basic understanding of medical terminology and anatomy Excellent communication skills both written and verbal Self‑starter that is detail oriented and capable of multi‑tasking Comprehensive knowledge of computer skills including Microsoft Office Suite Comfortable in a fast‑paced working environment of a growing practice At FOI our goal is to provide our patients with world‑class orthopedic care. Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encountered with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations. What we offer: Full time opportunities available, with room for career growth and advancement. Excellent job security and stability, to promote an optimal work life balance. Be part of this dynamic and growing high level team! Orthopaedic Solutions Management is a Drug Free Workplace We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug‑free workplace. All candidates will be required to undergo pre‑employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr