Revenue Cycle Specialist – Insurance Follow-Up

Join Max Surgical Specialty Management, an innovative leader in the healthcare industry, as we embark on an exhilarating journey of growth and expansion!
We are seeking a motivated and dynamic individual to join our Revenue Cycle Management Team as a Revenue Cycle Specialist – Insurance Follow-Up. 

What You'll Do:
The Revenue Cycle Specialist – Insurance Follow-Up will be responsible for all collection functions for oral surgery services. The primary responsibility of this position is account resolution, which includes the following duties: reviewing accounts, following up with insurance companies on claim status, gathering and submitting any missing information, rebilling, appeals, and billing out secondary electronic or paper claims to all payers as needed.
The successful candidate will be able to:

• Resolve billing discrepancies and claim denials through follow-up with insurance companies
• Maintain clear communication with management about billing and insurance details
• Review and interpret dental EOBs (Explanation of Benefits), including patient deductibles, co-pays, and insurance/third-party correspondence
• Research and navigate insurance policies, benefits, and exclusions to provide accurate information to patients & management team
• Manage A/R processes, including claims submissions and payment processing
• Monitor outstanding claims and follow up with insurances to ensure timely payments
• Verify insurance coverage and eligibility for patients
• Follow-up to all third-party payers and self-pay accounts documenting appropriate information thoroughly on accounts
• Process re-bill accounts as appropriate, and alert managers of any edits that may improve the billing process
• File all secondary insurance claims with appropriate EOB’s daily to avoid timely denials
• Obtain required attachments for claims submission from various EMR’s
• Review credit-balance accounts on a weekly basis
• Submit corrected claims or appeals to Medical and Dental insurance carriers for
• Performs appropriate adjustments, when required
• Gather payor trends and provide feedback to management
• Identify and resolve specific coding issues and provides feedback to management
• Work with internal revenue cycle and administrative teams to identify and manage 3rd party payor denials, overpayment, and underpayment issues
• Contact patients regarding coordination of benefits, insurance payments mailed to patients, and outstanding patient balances
• Assist patient billing & collections team to answer patient calls during high volume inbound calls periods
• Perform any and all other duties as assigned

• High School Diploma required, Medical Billing and or Coding Certification highly preferred
• 3 years of hands-on experience in healthcare revenue cycle management, with a proven track record of optimizing processes
• Proficient in all Microsoft Office applications as well as medical office software
• Proven experience in healthcare billing
• Sound knowledge of health insurance providers
• Strong interpersonal and organizational skills
• Excellent customer service skills
• The ability to work in a fast-paced environment

• Highly competitive salaries & annual performance and compensation reviews
• Competitive health insurance and benefits, including medical, dental, vision, disability, and more
• 401k retirement savings plan that includes employer match
• Generous Paid Time Off, sick leave, and paid holidays
• Advance your career growth with opportunities in the most extensive growing oral surgery practice in the Northeast

About MAX Surgical Specialty Management:

Established in September 2022 as the Northeast region’s first oral and maxillofacial surgery-only specialty platform, MAX Surgical Specialty Management is a surgeon-led management services organization developed with clinical and surgeon autonomy at its core. Today, MAX supports surgeons across New Jersey, New York, Pennsylvania, Vermont and Connecticut, enabling practices to channel resources, skills and knowledge within the oral surgery specialty, leading industry advancements and delivering the highest standard of patient care. Surgeons have access to a curated network that allows them to collaborate with and work alongside a diverse pool of highly skilled peers who are leaders in their specialty. MAX safeguards surgeons’ independence while offering robust support systems, access to advanced technology and opportunities for financial growth.

Integrity-driven. Patient-focused. Experience the difference at www.max-ssm.com.

MAX Surgical Specialty Management is an equal opportunity employer committed to providing fair employment opportunities regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, veteran status, or any other legally protected characteristic. We welcome diversity and encourage applicants from all backgrounds. Our inclusive environment values and empowers every employee to contribute to our mission.