Revenue Cycle Specialist: Denials & Reimbursements Expert

Unified Women’s Healthcare; Boca Raton (FL); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Health coverage

Paid time off

401(k) with employer contribution

Flexible Spending Accounts (FSAs) / HS

Health Savings Accounts (HSAs)

Employee Assistance Program

Job summary

Unified Women’s Healthcare is seeking a Revenue Cycle Specialist to resolve claims, denials, and discrepancies across payer networks. You will collaborate with practices and payers to ensure accurate reimbursement and timely resolutions, while generating actionable reports for leadership.

Ideal candidates have 2+ years in medical billing/collections, familiarity with OB/GYN billing, and experience with practice management systems and CRM tools. This is an on-site role supporting multiple clinics.

Qualifications

• Excellent verbal and written communication with internal and external customers.
• Experience interpreting insurance explanations of benefits and patient responsibility.
• 2+ years of medical claims, billing, collections and appeals experience, OB/GYN preferred.
• Familiarity with healthcare practice management systems (Athenanet preferred).
• Experience with cloud-based CRM technology (Salesforce preferred).
• Proficient with Microsoft Office, especially Excel.

Responsibilities

• Resolve Accounts Receivable and Collections, including follow up and appeals.
• Review, follow up and appeal denied claims according to standards.
• Determine accuracy of insurance payments and follow up on discrepancies.
• Initiate and respond on payer reimbursement issues.
• Communicate with practices and payers regarding denials and trends.
• Analyze and quality review work performed by third parties.
• Build and generate reports as needed.

Skills

Communication skills

Team collaboration

Insurance claims experience

EOB interpretation

Excel proficiency

Education

High school diploma or equivalent; post secondary degree preferred

Tools

Salesforce

Athenanet

Microsoft Excel

Job description

Unified Women’s Healthcare is seeking a Revenue Cycle Specialist to resolve claims, denials, and discrepancies across payer networks. You will collaborate with practices and payers to ensure accurate reimbursement and timely resolutions, while generating actionable reports for leadership.

Ideal candidates have 2+ years in medical billing/collections, familiarity with OB/GYN billing, and experience with practice management systems and CRM tools. This is an on-site role supporting multiple clinics.