Medical A/R Specialist: Denials & Appeals (Orthopedics)

South Florida Orthopaedics & Sports Medicine PA; Florida; On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Competitive compensation

Medical, dental, and vision insurance

401(k)

Paid time off and holidays

Ongoing professional development

Webinars and training programs

Modern revenue cycle tools

Collaborative management team

Long-term career growth

Job summary

South Florida Orthopaedics & Sports Medicine seeks an experienced Medical A/R Specialist to join our Revenue Cycle team in Stuart, FL. You will own accounts, resolve balances, and manage denials.

This role requires Medicare and commercial appeals, payer portal research, EOB interpretation, and collaboration with coding and management to recover revenue while maintaining high productivity and quality.

Qualifications

• Demonstrated success collecting and resolving medical accounts receivable balances.
• Recent experience preparing and filing appeals with Medicare and commercial payers.
• Experience using payer portals to check claim status and payment information.
• Experience with an EMR and Practice Management system (NextGen preferred).
• Ability to read and interpret EOBs and remittance advice.
• Strong communication and analytical problem-solving skills.

Responsibilities

• Investigate and resolve insurance claim denials and underpayments.
• Review EOBs, remittance advice, and payer correspondence.
• Prepare and submit appeals to Medicare and other payers.
• Research claim status through payer portals and resources.
• Identify reimbursement trends and escalate systemic issues.
• Resubmit corrected claims with supporting documentation.
• Collaborate with coding, billing, and management teams to resolve issues.
• Identify accounts that may be uncollectible and suggest resolutions.
• Maintain productivity and quality while managing work queues.

Skills

A/R collections

Denial management

Appeals processing

Payer communications

Analytical skills

Excel / MS Office

Attention to detail

Independent worker

Tools

NextGen EMR

Practice Management system

Payer portals

Microsoft Office

Job description

South Florida Orthopaedics & Sports Medicine seeks an experienced Medical A/R Specialist to join our Revenue Cycle team in Stuart, FL. You will own accounts, resolve balances, and manage denials.

This role requires Medicare and commercial appeals, payer portal research, EOB interpretation, and collaboration with coding and management to recover revenue while maintaining high productivity and quality.