ASC Revenue Specialist

ASC Revenue Specialist

Position Summary

OSMC is dedicated to providing the highest quality care for diseases and injuries of the musculoskeletal system within a patient-centered, service-driven environment. Our team works collaboratively to ensure every patient receives exceptional care and support throughout their treatment journey.

The Ambulatory Surgery Center (ASC) Revenue Specialist is responsible for a variety of revenue cycle functions, including patient billing, charge entry, payment posting, insurance claim processing, collections, and claims follow-up. This position plays a key role in ensuring accurate and timely reimbursement while providing excellent customer service to patients, insurance carriers, and internal staff. This role will work exclusively with patients over the telephone assisting the patient on their billing processes.

The ideal candidate will be detail-oriented, highly organized, and capable of multitasking in a fast-paced environment supporting two surgery center locations. Strong computer, communication, and customer service skills are essential.

Essential Functions and Responsibilities

• Handle incoming patient inquiries and respond to insurance company questions.
• Assist in identifying and resolving patient billing concerns and account discrepancies.
• Ensure appropriate collection of copayments, prepayments, deductibles, and self-pay balances.
• Monitor patient accounts and assist with payment arrangements as needed.
• Review, code, process, and submit insurance claims accurately and timely.
• Research and follow up on outstanding insurance claims to secure reimbursement.
• Enter surgical charges and verify accuracy of insurance and patient information.
• Correct claim errors and facilitate submission of clean claims.
• Post incoming insurance and patient payments accurately and promptly.
• Prepare claims for rebilling, reconsideration, or appeal when necessary.
• Appeal payment denials, underpayments, and incorrect insurance adjustments.
• Verify and process patient and insurance refunds.
• Gather and provide medical records for patients, insurance companies, attorneys, and courts as authorized.
• Respond to internal billing inquiries through telephone and email communication.
• Maintain strict patient confidentiality in accordance with HIPAA regulations.
• Perform other related duties as assigned.

Qualifications

• High school diploma or equivalent required.
• Prior medical billing, revenue cycle, or healthcare office experience required.
• Knowledge of insurance claims processing, medical terminology, and reimbursement practices preferred.
• Strong attention to detail and problem-solving skills.
• Proficiency with computer systems and electronic medical records.
• Excellent customer service, communication, and organizational skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.

This position offers the opportunity to play an integral role in supporting the financial operations of the Ambulatory Surgery Center while ensuring a positive experience for patients and providers alike.