Revenue Cycle Specialist, Bilingual – Spanish

This is a fully remote position, open to applicants in Florida.

📋 Description

• Prepare and submit healthcare claims, including conducting pre-bill claim edits/reviews and making manual updates to insurance and billing information.

• Submit claims to designated insurance providers, workers’ compensation, and occupational medical payers/employers in line with departmental protocols and relevant regulations.

• Offer coverage and support to various teams based on workload and priorities.

• Process credit card payments from payers and patients, including card-on-file transactions, utilizing InstaMed and NextGen.

• Supply documentation to payers to address workers’ compensation claim issues or denials as assigned.

• Investigate and follow up on outstanding accounts receivable for designated payers.

• Collaborate with payers, operational managers, and revenue cycle team members to address receivables, rebill claims, and file appeals.

• Update insurance, charge, and claims data to ensure precise billing and rebilling.

• Review, process, and follow up on payer and revenue-cycle correspondence on a daily basis.

• Distribute correspondence received via fax, mail, lockboxes, and payer portals to the appropriate RCM team members.

• Resolve returned patient statements efficiently.

• Analyze and address internal and external customer concerns received through billing inquiries and other communication channels.

• Provide phone coverage for the Corporate Customer Service Representative as needed.

• Deliver customer service and communication to both internal and external customers and team members.

• Accurately and promptly complete accounts receivable requests.

• Update daily NextGen reports, including the Employer Not on File report.

• Perform additional duties as assigned.

⛳️ Requirements

• Minimum of 2 years of relevant experience in healthcare billing, claims submission, payment posting, denials management, and/or accounts receivable follow-up.

• Experience in outpatient clinics, physician offices, hospitals, or a combination of these areas.

• Comprehensive understanding of CMS 1500 medical billing regulations and supporting documentation requirements for Medicare, Medicaid, workers’ compensation, or similar payers.

• Familiarity with ICD-10 diagnosis codes, CPT/HCPCS, modifiers, and medical terminology.

• Strong attention to detail and demonstrated analytical skills, with the ability to identify trends in denials and claims issues.

• Proficient in Microsoft Office, particularly Excel, Outlook, Word, Teams, OneNote, and SharePoint or similar applications.

• Experience with healthcare practice management or billing systems is preferred.

• High School diploma is required.

• An Associate degree or higher is preferred.

• Bilingual in Spanish is preferred.

• Capability to lift and/or move up to 40 pounds.

🏝️ Benefits

• Reasonable accommodations may be provided to facilitate individuals with disabilities in performing essential functions.

• Employees may have the option to work in-office or remotely, depending on company and/or departmental policies.