Job Description
Job Description
About Aptiva Medical
Aptiva Medical is a rapidly growing national leader in direct-to-consumer Continuous Glucose Monitor (CGM) supplies. We're on a mission to make diabetes management seamless for patients across America by providing convenient recurring deliveries and handling all the complexity of insurance billing—so patients can focus on their health, not paperwork.
The Opportunity
Our Revenue Cycle Management team is the engine that drives our growth. We're looking for exceptional problem-solvers who thrive on challenges, take ownership of outcomes, and aren't satisfied until every dollar of legitimate reimbursement is recovered.
What You’ll Do
Denials Management & Recovery (Primary Focus)
Work and resolve claim denials with urgency to maximize recovery rates
Identify denial patterns, complete root-cause analyses, and implement corrective actions
Prepare persuasive, well-documented appeals; track and report denial metrics
Collaborate with clinical / operations teams to eliminate systemic triggers
Claims Submission & QA
Perform front-end edits to ensure clean first-pass submissions
Submit / adjust electronic claims (Medicare, Medicaid, commercial) in real time
Maintain expert knowledge of payer-specific requirements
Payment Posting & Reconciliation
Post payments / adjustments with precision; reconcile remittances
Tie adjustments to correct GL accounts; investigate variances / underpayments
Insurance Verification & Documentation
Complete comprehensive verifications via portals and payer calls
Gather / validate documentation and respond to audit requests promptly
Accounts Receivable (AR)
Work AR aging to goals; resolve rejections to maintain cash flow
Make strategic outbound payer calls; process refunds / payment plans as needed
Compliance & Continuous Improvement
Adhere to Medicare / Medicaid and commercial payer regulations
Stay current on policy / coding updates; contribute to team training and process improvements
What You’ll Bring
Experience
2–4 years in medical billing, insurance reimbursement, or RCM
Demonstrated success resolving complex denials and lifting recovery rates
DME billing strongly preferred; Medicare Part B and / or Medicaid required
Technical Skills
Proficiency with electronic claim submission platforms
Strong ERA / EOB interpretation; high-accuracy data entry
Comfortable working across multiple systems; advanced Excel skills
Knowledge
Medicare / Medicaid compliance; CPT / HCPCS coding & modifiers
Payer contracts, allowables, reimbursement methodologies
AR principles (debits / credits, GL coding)
Core Competencies
Analytical, curious, and tenacious problem-solver
Clear written / verbal communicator (technical and non-technical)
Organized, self-directed, and accountable; calm under volume / pressure
Collaborative across clinical, operations, and customer service teams
Nice to Have
Bachelor’s in healthcare administration, business, or related field
CRCR or similar certification
Experience with CGM / diabetes supplies; exposure to Lean / Six Sigma
Why Aptiva
Impact : Your wins keep patients supplied without interruption
Autonomy : Own decisions and drive outcomes without red tape
Growth : Rapid expansion = real advancement opportunities
Team : Knowledge-sharing culture that celebrates wins
Schedule : Monday–Friday; no on-call
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Reimbursement Specialist • Fort Lauderdale, FL, US