Revenue Cycle Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Accurately prepare and submit claims to health plans within designated deadlines.

• Investigate denied and rejected claims, identify underlying issues, rectify errors, and resubmit as necessary.

• Identify and flag recurring denial and rejection trends to tackle problems at their origin.

• Track claim status and engage with health plans and RCM partners for follow-up.

• Assist in resolving payment discrepancies.

• Generate claims and billing reports, and aid in the month-end closing process.

• Ensure documentation remains organized and current.

• Take part in investigations, one-off clean-up tasks, and special projects.

• Conduct research on aged claims and payer-specific concerns.

• Collaborate with finance, product, and engineering teams on enhancements to claims data and processes or systems.

• Evaluate and provide insights on process or system improvements.

• Assist with billing inquiries and communications for both patients and health plans.

⛳️ Requirements

• 1-3 years of experience in medical billing, claims submission, or denials management.

• Familiarity with the basics of the claim lifecycle (CMS-1500/837 claims, CPT/ICD-10 coding, EOBs/ERAs, common denial reason codes).

• Proficient in Google Suite and Excel (including sorting, filtering, and ideally utilizing pivot tables and VLOOKUPs).

• Excellent written and verbal communication skills, with a preference for experience in liaising with health plans to resolve payment issues.

• Previous experience with EMR or RCM software (e.g., Candid) is advantageous.

• Experience in Medicaid or Medicare billing is beneficial.

• Familiarity with registered dietitian, nutrition services, and/or food billing is a plus.

• Detail-oriented, analytical, adaptable, inquisitive, capable of working independently, and knowing when to seek assistance.

🏝️ Benefits

• Remote-First Company.

• Unlimited PTO.

• Flexible and remote work location.

• Comprehensive Healthcare Coverage (Medical, Dental, Vision).

• 401k and performance bonus.

• Access to Registered Dietitian Sessions.

• Equal opportunity for employment and advancement.