Medical A/R Specialist

Medical A/R Specialist

South Florida Orthopaedics & Sports Medicine is seeking an experienced Medical A/R Specialist to join our growing Revenue Cycle team. If you enjoy solving complex claim issues, appealing denials, and recovering revenue that others may overlook, this is an opportunity to make a meaningful impact while working with a supportive and experienced team.

Since 1995, South Florida Orthopaedics & Sports Medicine has been a trusted provider of orthopaedic and musculoskeletal care on the Treasure Coast. Our multi-specialty practice includes orthopaedics, sports medicine, joint replacement, pain management, podiatry, physical therapy, and occupational therapy services. As our practice continues to grow, we are looking for skilled revenue cycle professionals who are passionate about maximizing reimbursement and improving financial outcomes.

As a Medical A/R Specialist, you will take ownership of assigned accounts and work independently to resolve outstanding balances and payer denials. Your responsibilities will include:

• Investigating and resolving insurance claim denials and underpayments
• Reviewing and interpreting EOBs, remittance advice, and payer correspondence
• Preparing and submitting appeals to Medicare, commercial insurance carriers, workers' compensation carriers, and auto insurance payers
• Researching claim status through payer portals and other available resources
• Identifying reimbursement trends and escalating systemic issues when appropriate
• Resubmitting corrected claims and supporting documentation
• Collaborating with coding, billing, and management teams to resolve complex reimbursement issues
• Identifying accounts that may be uncollectible and making recommendations for resolution
• Maintaining productivity and quality standards while managing assigned work queues

Our Revenue Cycle team is made up of experienced professionals who are trusted to manage their work with a high degree of independence and professional judgment. We are proud of the stability of our team and the supportive culture we have built. Many team members have been with the practice for years, creating an environment where knowledge is shared, collaboration is encouraged, and employees are valued for their contributions.

We offer:

• Competitive compensation
• Medical, dental, and vision insurance
• 401(k) retirement plan
• Paid time off and paid holidays
• Ongoing professional development opportunities
• Regular industry webinars and training programs
• Modern technology and up-to-date revenue cycle tools
• A collaborative, supportive management team
• Long-term career growth opportunities within a stable, growing healthcare organization

This is not an entry-level billing position. We are seeking an experienced medical accounts receivable professional who can independently research, analyze, and resolve complex reimbursement issues. Successful candidates will have a strong understanding of payer requirements, denial management, appeals, and medical claim resolution.

You are an experienced medical accounts receivable professional who enjoys investigating claim issues, navigating payer requirements, and seeing difficult accounts through to resolution. You are analytical, persistent, and detail-oriented, with the confidence to work independently while contributing to a collaborative team environment.

Successful candidates possess strong critical-thinking skills, communicate professionally with payers and colleagues, and take pride in recovering revenue accurately and efficiently.

Required:

• Demonstrated success collecting and resolving outstanding medical accounts receivable balances
• Recent experience preparing and filing appeals with Medicare and commercial insurance payers
• Experience utilizing payer portals to research claim status and payment information
• Experience with an EMR and Practice Management system; NextGen experience strongly preferred
• Ability to read, understand, and interpret EOBs and remittance advice
• Strong computer proficiency, including Microsoft Office applications
• Excellent written and verbal communication skills
• Strong analytical and problem-solving abilities

Preferred:

• Orthopaedic, surgical, or specialty practice experience
• Knowledge of CPT modifiers and medical coding concepts
• Experience with physical therapy and occupational therapy billing and reimbursement
• Experience handling workers' compensation and automobile insurance claims
• Familiarity with Medicare regulations and commercial payer reimbursement methodologies

Schedule:

• Full-time
• Monday through Friday
• 8:00 AM 5:00 PM
• This is an in-office position based in our Stuart, FL office

Physical Requirements:

• Primarily sedentary office work
• Frequent use of computers, telephones, scanners, and other office equipment
• Occasional lifting, carrying, bending, or stooping, up to 50 pounds

If you're looking for a position where your expertise is respected, your contributions make a measurable impact, and you can build a long-term career with a stable and successful organization, we encourage you to apply. Salary ranges shown on job search websites reflect market averages and do not reflect information specific to South Florida Orthopaedics. Candidates are encouraged to discuss compensation questions with Human Resources.