Sarasota Arthritis Center

Role Description The Billing Denial Specialist is responsible for proactively reviewing, researching, and resolving insurance claim denials to ensure timely reimbursement and minimize revenue loss for the Practice. This role plays a critical part in the revenue cycle by identifying denial trends, filing appeals, correcting claim issues, and working denials through to resolution. The ideal candidate is highly organized, detail-oriented, dependable, and able to work independently with minimal supervision. This individual must be a self-starter who takes initiative, remains proactive, and does not require constant direction to manage responsibilities effectively. This is a fully remote position. Only qualified applicants currently residing in Florida will be considered for employment. Key Responsibilities - Review denial reports daily and actively work all assigned insurance claim denials to resolution. - Research denied, underpaid, and rejected claims to determine root cause and appropriate corrective action. - Submit corrected claims, reconsiderations, and appeals in a timely manner. - Communicate with insurance carriers regarding claim status, appeals, and reimbursement issues. - Identify denial trends and escalate recurring payer or workflow issues to leadership. - Maintain accurate and detailed documentation of all follow-up activities within the practice management system. - Work collaboratively with billing, coding, authorizations, scheduling, and clinical teams to resolve claim issues. - Ensure compliance with payer guidelines, billing regulations, and practice policies. - Prioritize workload effectively to meet productivity and aging goals. - Follow through on unresolved claims until final determination or payment is received. - Assist with special revenue cycle projects and additional duties as assigned. - Other duties as assigned. This job description is not designed to cover or contain a comprehensive list of activities, duties, or responsibilities that are required of the employee. They may change, or new ones may be assigned at any time with or without notice. Qualifications - Minimum of 3 years of medical billing and denial management experience preferred. - Experience working with commercial insurance, Medicare, Medicaid, and managed care payers. - Strong understanding of medical billing, claims processing, EOBs, appeals, and denial resolution. - Knowledge of CPT, ICD-10, and HCPCS coding preferred. - Experience with EMR and practice management systems preferred. - Proficiency with Microsoft Office and payer portals. - Ability to manage multiple priorities and meet deadlines. - Knowledge of HIPAA regulations and ability to maintain confidentiality. - Strong analytical and problem-solving skills. - Excellent attention to detail and organizational skills. - Self-motivated, proactive, and dependable. - Strong written and verbal communication skills. - Ability to identify opportunities for process improvement and workflow efficiency. - Professional, positive, and team-oriented attitude. Benefits - 100% employer-paid medical insurance for employees. - 401(k) with company match and employer-funded profit sharing. - Four-day work week (Monday – Thursday), supporting strong work/life balance. - Paid holidays and Paid Time Off (PTO). - A collaborative, team-oriented culture with strong support and a shared commitment to exceptional patient care.

Role Description The Infusion Scheduler is responsible for coordinating and scheduling initial infusion appointments, follow-up infusion visits, and maintaining efficient daily infusion schedules within a fast-paced rheumatology practice. This role plays a critical part in optimizing infusion chair utilization, supporting patient access to care, and ensuring efficient infusion suite operations. The ideal candidate is highly organized, proactive, detail oriented, and able to manage scheduling workflows while providing exceptional customer service to patients and clinical staff. This is a fully remote position; however, employees must reside within the state of Florida. Key Responsibilities - Infusion Scheduling & Coordination - Schedule initial infusion appointments and recurring follow-up infusion visits. - Coordinate infusion schedules based on medication protocols, infusion duration, provider orders, and chair availability. - Maintain accurate infusion schedules for all applicable suite locations. - Work with infusion nurses, infusion/biologic coordinators, providers, and office staff regarding scheduling needs and patient flow. - Work closely with providers, medical assistants, and onsite managers regarding scheduling needs and patient flow. - Maintain scheduling accuracy and ensure appropriate appointment durations are utilized. - Schedule Optimization - Monitor infusion schedules throughout the day and proactively address scheduling gaps, cancellations, and changes. - Contact patients regarding earlier appointment availability or schedule openings. - Assist in optimizing infusion chair utilization and maintaining efficient patient flow. - Maintain waitlists and assist with rescheduling appointments as needed. - Communicate schedule updates and changes promptly to patients and staff. - Patient Service - Provide exceptional customer service to patients, providers, and staff. - Answer incoming scheduling calls professionally and efficiently. - Accurately document scheduling communications and appointment notes within the electronic medical record (EMR) system. - Educate patients regarding infusion appointment scheduling, arrival times, and general appointment instructions. - Maintain strict patient confidentiality and professionalism. - Administrative - Verify patient demographics and insurance information during scheduling. - Maintain accurate provider calendars and scheduling templates. - Follow organizational scheduling workflows, policies, and productivity expectations. - Assist with additional administrative and operational duties as assigned. - Follow all OSHA, HIPAA, and SAC privacy and safety standards. - Other duties as assigned. Qualifications - High school diploma or equivalent required. - Minimum of 2 years of medical scheduling or healthcare administrative experience preferred. - Strong communication and customer service skills. - Ability to multitask in a fast-paced environment. - 1+ year experience in rheumatology, internal medicine, or other specialty practice, preferred. - Experience with EMR systems; familiarity with NextGen is a plus. - Strong organizational skills. - Strong attention to detail and problem-solving abilities. - Ability to prioritize tasks and adapt to changing schedules. Equal Employment Opportunity Sarasota Arthritis Centers provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.