The Cardiac & Vascular Institute · 1 day ago
Billing Specialist lll
Gainesville, FL
Full-time
Onsite
Senior Level
5+ years expThe Cardiac and Vascular Institute is dedicated to providing advanced healthcare services, and they are seeking a Billing Specialist III to support their vision and mission. This senior-level role involves performing advanced billing and accounts receivable functions, managing complex account resolutions, and providing guidance to junior staff to optimize revenue integrity.
Health Care
Responsibilities
Serve as the primary owner for researching and resolving unapplied payments, unidentified funds, and credit balances
Perform root-cause analysis related to unapplied cash, including posting errors, missing or incorrect charges, payer variances, and workflow gaps
Perform advanced billing and payment posting functions, ensuring accuracy and compliance with payer requirements
Research, analyze, and resolve complex billing discrepancies, underpayments, denials, and claim rejections
Interpret payer remittance advice and explanations of benefits (EOBs) to determine appropriate follow-up actions
Initiate, prepare, and follow up on insurance reconsiderations and appeals to maximize reimbursement
Identify denial trends and root causes; escalate findings and recommend corrective actions to prevent future denials
Evaluate patient financial responsibility and assist in identifying appropriate payment solutions when needed
Ensure accounts are accurately updated to a billable and collectible status in a timely manner
Support optimization of electronic claim submission by correcting errors identified in payer reports
Assist with accurate and timely write-offs of uncollectible accounts in accordance with departmental policies
Maintain strict confidentiality and comply with HIPAA and all applicable regulations
Perform other duties and responsibilities as assigned
Qualification
Required
High School Diploma or equivalent (GED)
Minimum of 5+ years of progressive experience in medical billing and/or insurance accounts receivable
Advanced knowledge of medical billing, insurance accounts receivable, and payer reimbursement methodologies
Strong working knowledge of payer-specific requirements, policies, LCDs, and NCDs
Demonstrated ability to analyze data, identify trends, and recommend process improvements
Exceptional attention to detail and accuracy
Ability to work independently while also functioning effectively as part of a team
Strong organizational, time management, and multitasking skills in a deadline-driven environment
Proficiency with billing systems, EHRs, and Microsoft Office applications
Effective verbal and written communication skills when interacting with patients, payers, and leadership
Ability to exercise sound judgment and escalate issues appropriately
Willingness to adapt to evolving workflows, technologies, and payer regulations
Preferred
Cardiology or cardiovascular healthcare experience
Prior experience handling advanced denials, appeals, and complex payer issues
Company
The Cardiac & Vascular Institute
Mission Statement: Our mission is to be the cardiovascular provider of choice to the people of North Central Florida by delivering state of the art comprehensive cardiac services with compassion, dignity, and professionalism.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase