Revenue Specialist I

US-FL-Land O'Lakes
# Positions
Office and Administrative Support
Job Status
Regular Full-Time
2150 Via Bella Boulevard

Job Description

Revenue Specialist I

Department:               CBO

Job Summary:           Performs patient accounting functions including billing, collections, customer service, and cash applications; documents patient account activity; responds to customer billing inquiries; posts payments; implements billing guideline changes and identifies trends at a payer specific level; applies federal and state guidelines to collection efforts; interprets and follows up on Explanation of Benefits; inventories supplies; reports and tracks equipment maintenance; performs other duties as assigned by management.

Reports to:                 Collection Manager

Position Level:           6



Essential Functions of the Position: 

  • Run and work a Summary Aging  Report Monthly:
    • Work all accounts aging 30 days and greater by Insurance/Provider.
    • Contact the Insurance carrier to confirm claims are on file and in process to pay.
    • Review explanation of benefits to ensure the claims have processed per our contractual agreement.             
  • Run and work Denial Work List report weekly:
    • Identify any claims that have denied and contact the carrier.   All denials should be appealed for medical necessity when warranted. 
    • Clinical task the office or billing department if the denial is related to no authorization, diagnosis/cpt conflict, etc.
    • Review and work all clinical tasks within 7 business days.
    • Resubmit any corrected claims for reimbursement.
    • (Any Insurance denial trends should be brought to the attention of the Collection Manager). 
  •  Prepare for Monthly Divisional Meetings
    • Collectors should run AR for meetings.
    • All accounts should be documented.
    • Review any claims that may have denied that are not on the denial work list report. 
  • Quality and Quantity of work
    • Work mail daily
    • Work all adjustments, any over $75.00 must have prior approval from the Collections Manager which is approved weekly.
    • Write up refunds requests from Insurance carriers that do not recoup. 
  • Job Knowledge/Contractual Reimbursement:                        
    • Knowledge of contractual reimbursement per Specialty.
    • Review CCI/CPT for correct billing.
    • Understand site of service differentials
    • Understand when multiple surgical reductions apply.
    • Identify underpaid/overpaid claims                        

 Additional Responsibilities: 

  • Prepare for monthly divisional meetings.
  • Access Claims Tracker.
  • Access ERA Manager.
  • Utilize the Internet for multiple job requirements.
  • Rebill all 2ndry claims that are not on file.
  • Contact the patient for additional information when necessary.
  • Assist patient with any billing or collection questions.
  • Fax claims to carriers to ensure claims are received.
  • Reallocate misapplied payments and adjustments.
  • Work special assignments as needed. 


  • Maintain an organized and clean work area.
  • Phone etiquette.
  • Quantity and quality of work overall.
  • Adheres to FMC policies and procedures 

Physical and Mental Demands:

  • Normal physical ability to sit for long periods of time while on the phone.
  • Maintaining a positive and professional attitude.
  • Able to handle stressful situations.
  • Able to meet deadlines. 

Job Qualifications:

  • High school graduate or GED equivalent
  • Excellent telephone etiquette
  • Basic computer knowledge
  • Analytical skills
  • Ability to manage multiple tasks
  • Prior collection experience
  • Computer skills (Internet, Excel, Word, etc)
  • Communications skills, written and verbal
  • Strong Team Player
  • Above average proficiency in use of 10 key 
  • Minimum of one year related experience preferred



Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Connect With Us!