Revenue Cycle and Managed Care Specialist

About the role

Addison Group is hiring for our client, an established healthcare management organization supporting 14 Ambulatory Surgery Centers (ASCs) nationwide. We are seeking a Revenue Cycle & Managed Care Specialist with a strong foundation in ASC/outpatient surgery reimbursement, collections, and payer follow-up. This is an excellent opportunity for someone ready to expand beyond traditional AR and gain experience in managed care, payer contracting, credentialing, enrollment, and fee schedule management. The team is willing to train on many aspects of the position. The most important qualification is understanding how outpatient surgery claims are reimbursed and how to investigate when they don't pay correctly.

Responsibilities

• Research denied, underpaid, and incorrectly reimbursed claims
• Determine expected reimbursement using payer contracts and fee schedules
• Identify root causes of payment discrepancies and work issues through resolution
• Communicate with insurance carriers and navigate payer/provider portals
• Review payer contracts and reimbursement terms
• Assist with commercial payer, Medicare, and Medicaid enrollment
• Support credentialing and recredentialing
• Maintain payer contracts and fee schedules across multiple ASCs
• Help ensure updated fee schedules are accurately loaded into billing systems
• Assist with managed care contracting and bundled payment programs
• Troubleshoot payer and Revenue Cycle issues as they arise
• Use Excel for tracking, analysis, and operational support

Qualifications

• 2–3+ years of healthcare Revenue Cycle experience
• ASC or outpatient surgery collections/AR experience strongly preferred
• Understanding of ASC/outpatient surgery reimbursement
• Knowledge of commercial and Medicare reimbursement
• Basic understanding of CPT codes
• Experience researching denials, underpayments, and payer discrepancies
• Ability to read and understand payer contracts
• Comfortable communicating directly with insurance payers
• Strong analytical and problem-solving skills
• Ability to manage changing priorities in a fast-paced environment
• Managed care or payer contracting experience (nice to have)
• Credentialing/recredentialing experience (nice to have)
• Medicare or Medicaid enrollment experience (nice to have)
• Fee schedule experience (nice to have)
• Strong Microsoft Excel skills (nice to have)

Benefits

• Medical
• Dental
• Vision

Pay

$25–$35/hour, based on experience

Schedule

Monday–Friday, flexible daytime hours