Revenue Cycle Specialist

Position Overview We are seeking a highly skilled and detail-oriented Revenue Cycle Specialist with comprehensive, hands-on experience across the full medical billing lifecycle. This role requires demonstrated expertise in charge entry review, clean claims submission, payment posting, insurance verification, claims and appeals management along with a strong understanding of how each function contributes to overall revenue integrity and performance. The ideal candidate will possess in-depth knowledge of insurance guidelines, CPT and ICD-10 coding standards, reimbursement methodologies, and end-to-end revenue cycle operations, with the ability to proactively identify issues, ensure timely and accurate claim processing, and drive resolution of billing and reimbursement discrepancies. This position plays a key role in optimizing financial outcomes while maintaining compliance with all regulatory and payer requirements. Key Responsibilities Perform accurate and timely charge entry review and ensure proper documentation supports all billed services Submit clean claims in a timely manner, ensuring compliance with CPT, ICD-10, and payer-specific billing guidelines Complete payment posting (EOBs/ERAs) with a high level of accuracy, identifying discrepancies, denials, and underpayments Conduct insurance verification to confirm eligibility, benefits (as needed) Manage accounts receivable (A/R) by working aging reports and performing consistent claims follow-up with payers Prepare and submit appeals and reconsiderations, including gathering and reviewing medical records and supporting documentation Investigate and resolve denials, rejections, and payer issues, ensuring timely rebilling and reimbursement Analyze payer trends, underpayments, and recurring issues; recommend process improvements Ensure compliance with Medicare, Medicaid, and commercial payer guidelines, as well as HIPAA regulations Collaborate with providers, front office, and clinical staff to resolve billing and documentation issues Perform routine billing audits to ensure accuracy in coding and reimbursement Required Qualifications Minimum 3+ years of medical billing/revenue cycle experience Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment Strong analytical, problem-solving, and communication skills Ambulatory Surgery Centers (ASC) billing experience Preferred Qualifications Experience with Modernizing Medicine (ModMed/EMA) software Gastroenterology billing experience

Pay:

$20.00 - $24.00 per hour

Work Location:

In person