Revenue Cycle Specialist- Surgical Claims

NSN Revenue Resources; New Hampshire; Remote; USD 45,000 - 65,000; Full time

Job summary

Join a dynamic team at NSN Revenue Resources as a Revenue Cycle Specialist focused on Surgical Claims. In this important role, you will manage accounts receivable, resolve claims, and ensure accurate payment processing for ambulatory surgery centers. The position offers competitive salary and benefits, with opportunities for growth, as well as remote work options for qualified candidates.

Qualifications

• 2+ years of ASC revenue cycle or orthopedic collections experience preferred.
• Strong understanding of medical billing, insurance reimbursement, denials, and appeals.
• High School Diploma or equivalent.

Responsibilities

• Resolve outstanding claims for maximum reimbursement including unpaid or denied.
• Verify patient balances and follow up for payments.
• Negotiate payment amounts with Third Party Administrators.

Skills

Communication

Attention to Detail

Negotiation

Multi-tasking

Education

High School Diploma or equivalent

Tools

Microsoft Office

Advantx

Vision

HST

Waystar

Job description

Revenue Cycle Specialist- Surgical Claims

Join to apply for the Revenue Cycle Specialist- Surgical Claims role at NSN Revenue Resources.

We are seeking an experienced and detail-oriented Accounts Receivable Specialist to join our central billing office team for ambulatory surgery centers. The successful candidate will play a crucial role in resolving outstanding surgical claims to maximize reimbursement.

Responsibilities

• Follow-up and resolve all outstanding A/R, including unpaid, underpaid, or denied claims for all payers, to obtain maximum reimbursement.
• Prioritize high-dollar claim balances through work queues.
• Review and process incoming insurance and patient correspondence, including refund requests.
• Send appeals or provide requested medical documentation as needed.
• Review medical documentation to justify medical necessity.
• Verify patient balances for accuracy and follow up with patients for payments.
• Handle incoming patient calls to resolve inquiries and billing issues.
• Review insurance payments and verify reimbursement accuracy based on contracts and fee schedules.
• Utilize knowledge of Medicare, Medicaid, and LCDs for claim resolution.
• Negotiate payment amounts with Third Party Administrators for out-of-network providers.
• Recommend adjustments or refunds for overpayments, providing proper documentation.

Requirements

• 2+ years of ASC revenue cycle or orthopedic collections experience preferred.
• Strong understanding of medical billing, insurance reimbursement, denials, and appeals.
• Ability to interpret EOBs and managed care contracts.
• Excellent communication skills.
• Ability to multi-task and meet deadlines.
• Intermediate proficiency in Microsoft Office, including Excel and Outlook.
• Experience with Advantx, Vision, HST, Waystar preferred.
• High School Diploma or equivalent.

We offer a competitive salary, benefits, and opportunities for growth. This is a remote position only if you are not within reasonable travel distance to our offices in Dallas, TX, Tampa, FL, or Sioux Falls, SD. ASC billing experience is required for remote work.

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Accounting/Auditing and Finance