Revenue Cycle Specialist

Unified Womens Health Care; Boca Raton (FL); Vor Ort; USD 52.000 - 76.000; Vollzeit

Benefits dieser Stelle

Health coverage

Paid Time Off

401(k) with employer contribution

Short- and long-term disability

Wellbeing support

Professional development

Zusammenfassung

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.

Qualifikationen

• 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.

Aufgaben

• 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.

Kenntnisse

Insurance claims interpretation

Medical billing & coding

Accounts Receivable & Collections

Communication skills

Team collaboration

Ausbildung

High school diploma or equivalent

Post-secondary degree preferred

Tools

Athenanet

Salesforce

Microsoft Excel

Jobbeschreibung

Overview

Unified is a nationwide community of providers, operations specialists and thought leaders who look for the greatest opportunities to impact every woman’s health, at every stage of their journeys. We are unparalleled in our scale and ability to adapt to address unmet and underserved needs. Through 815+ clinics, 23 IVF labs, nationwide telehealth capabilities and targeted case management, our 2,700+ independent, affiliated providers deliver comprehensive women’s health services and continuously work to implement methods and develop techniques or platforms that improve the healthcare experience. We remain focused on enabling the discovery of new ways for our affiliated providers to deliver the high-quality care experience women deserve, in the ways they most wish to receive it, and collaborate across our community to make our vision a reality.

The Revenue Cycle Specialist is responsible for resolving claim issues including A/R denials, payment variances, and any other unresolved issues that may arise directly from internal and external customers. There is an expectation of consistent and clear communication to multiple internal and external entities to collaborate and resolve issues. Duties include but are not limited to:

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

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

We’re here for you—both personally and professionally.

Our benefits are designed to support you and your family at every stage of life. From health and wellness to financial security and career growth, we offer a comprehensive package to help you thrive.

Here’s a look at what we offer:

Health Coverage

Medical, dental, and vision plans, fertility benefits, and supplemental insurance options.

Paid Time Off

Vacation, personal days, and paid holidays to help you recharge.

Financial & Retirement Planning

401(k) with employer contribution, plus Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs).

Income Protection

Short- and long-term disability, paid parental leave, basic life insurance, and optional additional coverage.

Wellbeing Support

Employee Assistance Program, commuter benefits, pet insurance, and identity theft protection.

Professional Development

Opportunities and resources to support your career growth.

• 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

We’re here for you—both personally and professionally.

Our benefits are designed to support you and your family at every stage of life. From health and wellness to financial security and career growth, we offer a comprehensive package to help you thrive.

Here’s a look at what we offer:

Health Coverage

Medical, dental, and vision plans, fertility benefits, and supplemental insurance options.

Paid Time Off

Vacation, personal days, and paid holidays to help you recharge.

Financial & Retirement Planning

401(k) with employer contribution, plus Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs).

Income Protection

Short- and long-term disability, paid parental leave, basic life insurance, and optional additional coverage.

Wellbeing Support

Employee Assistance Program, commuter benefits, pet insurance, and identity theft protection.

Professional Development

Opportunities and resources to support your career growth.

• 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