Medical Revenue Cycle Specialist

Unified Womens Health Care; Boca Raton (FL); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Health coverage

Paid Time Off

401(k) with employer contribution

Short- and long-term disability

Wellbeing support

Professional development

Job summary

Unified Womens Health Care is seeking a Revenue Cycle Specialist to resolve accounts receivable and denial issues, review insurance payments, and follow up with practices and payers. The role requires experience with medical claims, billing, and CRMs, plus strong communication and collaboration skills.

The position offers a comprehensive benefits package and opportunities for professional development, with a focus on accuracy and cross-functional teamwork to improve workflows across the network.

Qualifications

• High school diploma or equivalent; post secondary degree preferred.
• Minimum of 2 years current experience interpreting insurance explanation of benefits, patient benefit plans; policy coverage and patient responsibility.
• Minimum of 2 years current experience working with medical claims, billing and collections, and appeals; OB/GYN specialty preferred.
• Experience working with healthcare practice management systems, (Athenanet preferred).
• Experience working with cloud-based Customer Relationship Management (CRM) technology (Salesforce preferred).
• Experience with Microsoft Office with proficiency with Microsoft Excel.
• Excellent verbal and written communication skills with internal and external customers.
• Ability to collaborate effectively in a cross-functional team environment.
• Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals (Availity, Navinet, Optum, etc.) including billing guidelines and policy updates.
• Working knowledge of Medical Billing & Coding required, Certification preferred.

Responsibilities

• Resolve Accounts Receivable and Collections, including.
• Review, Follow Up, and Appeal denied claims according to standards.
• Determine accuracy of Insurance payments and follow up on discrepancies.
• Initiate, Follow Up, and Respond on payer reimbursement issues.
• Communicate with Practices and Payers regarding claim denials and payer trends.
• Analysis and Quality Review of work completed by third parties.
• Build and generate reports, as needed.

Skills

Insurance claims interpretation

Medical billing & coding

Accounts Receivable & Collections

Communication skills

Team collaboration

Education

High school diploma or equivalent

Post-secondary degree preferred

Tools

Athenanet

Salesforce

Microsoft Excel

Job description

Unified Womens Health Care is seeking a Revenue Cycle Specialist to resolve accounts receivable and denial issues, review insurance payments, and follow up with practices and payers. The role requires experience with medical claims, billing, and CRMs, plus strong communication and collaboration skills.

The position offers a comprehensive benefits package and opportunities for professional development, with a focus on accuracy and cross-functional teamwork to improve workflows across the network.