Revenue Cycle Specialist: Healthcare Claims & Denials

Unified Women’s Healthcare, LP; Florida; 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

Employee Assistance Program

Commuter benefits

Professional Development

Job summary

Unified Women’s Healthcare, LP is hiring a Revenue Cycle Specialist to resolve A/R issues, analyze payment variances, and coordinate with practices and payers. The role emphasizes accurate denial handling, payer communications, and reporting, with a focus on OB/GYN accounts.

The ideal candidate has 2+ years in medical billing/claims, proficiency with Excel, and experience with CRM and billing systems. This on-site position offers benefits and growth opportunities within a nationwide women’s

Qualifications

• Minimum 2 years experience interpreting insurance explanations of benefits, patient benefit plans; policy coverage and patient responsibility.
• Minimum of 2 years experience with medical claims, billing, collections, and appeals; OB/GYN preferred.
• Experience with healthcare practice management systems (Athenanet preferred).
• Experience with cloud-based CRM technology (Salesforce preferred).
• Experience with Microsoft Excel and Office.
• Excellent verbal and written communication 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) including billing guidelines.
• Working knowledge of Medical Billing & Coding; certification preferred.

Responsibilities

• Resolve Accounts Receivable and Collections.
• 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

Accounts Receivable

Interpreting insurance explanations of

Excellent verbal and written comm

Cross-functional collaboration

Medical Billing & Coding

Education

High school diploma or equivalent

Post secondary degree preferred

Tools

Athenanet

Salesforce

Availity

Navinet

Optum

Microsoft Excel

Job description

Unified Women’s Healthcare, LP is hiring a Revenue Cycle Specialist to resolve A/R issues, analyze payment variances, and coordinate with practices and payers. The role emphasizes accurate denial handling, payer communications, and reporting, with a focus on OB/GYN accounts.

The ideal candidate has 2+ years in medical billing/claims, proficiency with Excel, and experience with CRM and billing systems. This on-site position offers benefits and growth opportunities within a nationwide women’s