Back-End Revenue Cycle Specialist AICA Orthopedics is Atlanta's premier integrated healthcare provider, with 21 locations and a state-of-the-art surgery center. For 25 years, we have delivered exceptional multidisciplinary orthopedic, neuro-spine, and pain management care through a team of 400+ professionals. Our Revenue Cycle team is the financial engine that keeps it all running.The Back-End Revenue Cycle Specialist is responsible for the downstream functions that convert billed services into collected revenue. This role sits at the critical intersection of accounts receivable management, denial resolution, payment reconciliation, and collections follow-up directly determining how much of what we bill we actually get paid.Where front-end staff open the door for clean claims, you are the one who makes sure payment comes through it. Your accuracy in posting, your persistence in collections, and your analytical approach to AR aging are what separate billed revenue from collected revenue.When hired, you will be placed in one primary function AR follow-up, collections, or payment posting based on your experience and team need. This posting exists to connect us with qualified candidates across all three areas.Core ResponsibilitiesAccounts Receivable ManagementWork AR aging reports daily, prioritizing accounts by balance, payer, and days outstanding to maximize recoveryIdentify and resolve claim holds, rejections, and unpaid balances within established follow-up timeframesContact payers via phone, portal, and correspondence to obtain claim status and drive resolutionEscalate accounts approaching timely filing limits or contractual deadlines to prevent revenue write-offMaintain accurate AR notes and document all account activity, contacts, and next steps in the systemReduce days in AR for assigned payer segments through consistent, systematic follow-upDenial Management & AppealsReview explanation of benefits (EOBs) and remittance advice to identify denial reason codes and determine the correct resolution pathResearch and appeal denied or underpaid claims using supporting clinical documentation, medical records, and payer policy knowledgeRecognize denial patterns across payers and accounts and escalate systemic issues to prevent recurring revenue lossTrack appeal outcomes and adjust strategies based on payer-specific trends and timely filing windowsCoordinate with billing, coding, and clinical teams to obtain documentation needed to support successful appealsPayment Posting & ReconciliationPost insurance payments, adjustments, and contractual write-offs accurately against patient accounts from EOBs and ERAsIdentify and work underpayments by reconciling posted amounts against contracted fee schedulesBalance daily payment batches and resolve discrepancies between posted and deposited amountsProcess secondary claim submissions following primary payer adjudicationApply patient payments and coordinate with patient accounts team on balance billing as neededEnsure all posting is completed within established daily and weekly productivity targetsCollections Follow-UpConduct systematic outbound follow-up on outstanding insurance and patient balancesCommunicate professionally with payer representatives, attorney offices, and patients to resolve account balancesIdentify accounts appropriate for escalation, write-off review, or bad debt referral per departmental policyMeet or exceed monthly collection targets for assigned payer portfolios or account queuesDocument all collection activity and maintain accurate account statuses in NextGen and SalesforceReporting & Process ImprovementGenerate and interpret AR aging, denial, and collection reports to identify trends and opportunitiesSurface recurring root causes coding errors, authorization gaps, credentialing issues to the appropriate team for upstream correctionContribute to departmental performance goals for clean claim rates, collection percentages, and days in ARSupport audits and payer reconciliation projects as assignedPerformance ExpectationsSuccess is measured by outcomes. Top performers in this role consistently:Reduce days in AR for assigned accounts through disciplined, timely follow-upAchieve strong appeal overturn rates through thorough documentation and payer knowledgePost payments accurately with minimal corrections or batch discrepanciesMeet or exceed monthly collection targets for assigned payer queuesProactively identify systemic issues and escalate before they compound across multiple accountsQualificationsRequired2+ years of experience in back-end medical billing, AR follow-up, payment posting, or insurance collectionsWorking knowledge of EOBs, ERAs, remittance advice, and denial reason codesUnderstanding of insurance reimbursement processes, contracted rates, and medical billing workflowsProficiency with MS Office, particularly Excel; experience with practice management or EHR systemsStrong analytical and problem-solving skills with a detail-oriented, follow-through mindsetAbility to manage a high-volume account queue independently while meeting productivity and accuracy standardsPreferredExperience with NextGen, Salesforce, or similar healthcare/CRM platformsBackground in orthopedic, neuro-spine, physical therapy, or personal injury billingKnowledge of personal injury med pay, major medical, and lien-based billing environmentsFamiliarity with secondary claim submission and coordination of benefits processesCPC, CPMA, CRCR, or other revenue cycle certification (or actively pursuing)Bilingual in Spanish and English (preferred)The ideal candidate treats their AR queue like a case file every account has a story and you are going to work it until it's resolved. You know the difference between a denial you can appeal and one that needs a different fix upstream. You post payments with precision because you understand that a bad post creates a ripple of problems. You are persistent without being reactive, organized without being rigid, and analytical enough to see patterns that others miss.Compensation & BenefitsCompetitive hourly rate commensurate with experiencePerformance-based bonus potentialComprehensive benefits: medical, dental, vision, 401(k)Professional development support including certification assistance and continuing educationClear advancement pathway: Senior Specialist ? Team Lead ? ManagerWork Environment40 hours per week; occasional extended hours during peak periods or month-end closeIn-office position based at AICA Orthopedics headquarters in Marietta, GAFast-paced, metrics-driven environment with clear performance expectationsCollaborative team structure with experienced revenue cycle leadershipAICA Orthopedics / ProCo LLC is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
