Job Summary
The Revenue Cycle Specialist is responsible for maximizing the financial performance of Orlando Epilepsy Center by managing all aspects of the physician revenue cycle, from charge capture through final payment resolution. This position requires an experienced healthcare revenue cycle professional with extensive knowledge of medical billing, insurance claims processing, coding compliance, accounts receivable management, denial resolution, payment reconciliation, and reimbursement optimization.The successful candidate must be highly organized, analytical, and capable of working independently in a fast-paced, high-pressure environment with changing priorities and deadlines. This individual is expected to maintain a relentless focus on reducing accounts receivable, accelerating cash collections, improving billing accuracy, and achieving established key performance indicators (KPIs).The Revenue Cycle Specialist must demonstrate initiative, adaptability, and a willingness to assume new responsibilities, special projects, and operational challenges as they arise. Success in this role requires exceptional attention to detail, strong problem-solving skills, and a commitment to continuous process improvement while maintaining compliance with all payer and regulatory requirements.Required Qualifications
- Minimum of five (5) years of progressive experience in physician practice revenue cycle management.
- Extensive knowledge of healthcare reimbursement, medical billing, insurance claims processing, and accounts receivable management.
- Strong understanding of CPT, ICD-10-CM, HCPCS Level II coding, modifiers, medical necessity requirements, and payer billing guidelines.
- Demonstrated experience auditing provider documentation and medical coding for accuracy and compliance.
- Proven success managing insurance accounts receivable, reducing aging balances, and maximizing collections.
- Experience researching, resolving, and appealing insurance claim denials and underpayments.
- Advanced proficiency in Microsoft Excel, including Pivot Tables, XLOOKUP/VLOOKUP, formulas, filtering, sorting, reporting, and data analysis.
- Basic working knowledge of Microsoft Word for creating, editing, and formatting business documents and correspondence.
- Demonstrated experience using payer portals to verify eligibility, research claim status, submit appeals, obtain prior authorizations, and resolve reimbursement issues.
- Experience working with electronic claim submission, clearinghouses, electronic remittance advice (ERA), electronic funds transfer (EFT), and payment reconciliation.
- Working knowledge of Medicare, Medicaid, commercial insurance carriers, workers' compensation, and managed care reimbursement methodologies.
- Ability to identify billing trends, analyze payer behavior, and recommend workflow improvements that increase reimbursement and reduce denials.
- Strong analytical, organizational, and critical-thinking skills.
- Excellent verbal and written communication skills.
- Ability to work independently with minimal supervision while managing multiple priorities and deadlines.
- Ability to perform effectively in a fast-paced, high-pressure environment while consistently meeting productivity and quality expectations.
- Willingness to accept additional responsibilities, participate in special projects, and adapt to changing operational priorities.
- Strong commitment to maintaining focus on reducing accounts receivable and improving organizational cash flow.
Preferred Qualifications
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Revenue Cycle Representative (CRCR), or equivalent healthcare revenue cycle certification.
- Experience working in a neurology, epilepsy, or other physician specialty practice.
- Experience using AdvancedMD Practice Management and Electronic Health Record (EHR) software.
- Experience working with major payer portals, including Medicare Administrative Contractors (MACs), Medicaid portals, Availity, and commercial insurance carrier websites.
- Experience developing operational reports, dashboards, and revenue cycle performance metrics.
- Demonstrated ability to identify operational inefficiencies and implement process improvements that enhance reimbursement, reduce denials, and improve overall revenue cycle performance.
Pay: $22.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
