Revenue Cycle Specialist – Contract

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

📋 Description

• Address patient billing and insurance queries through Zendesk while adhering to established SLAs.

• Resolve inquiries related to financial responsibilities, disputes over statements, and requests for payment arrangements.

• Make outbound calls to patients and insurance providers to address billing concerns and follow up on claims.

• Provide education to patients regarding healthcare billing and insurance concepts, such as coverage, copayments, deductibles, EOBs, and telehealth billing.

• Establish and record payment plans and arrangements using Athena.

• Oversee patient accounts receivable follow-up, which includes reviewing statements, researching balances, making corrections, processing refunds, and issuing rebills.

• Implement the patient financial discharge process.

• Record patient interactions in both Athena and Zendesk.

• Manage claim holds and denial queues in Athena, focusing on aged and high-value accounts.

• Investigate claim status, eligibility, benefits, and denial details through payer portals and Availity.

• Collaborate with clinical teams and providers regarding requests for documentation addendums.

• Work with credentialing to resolve claim holds associated with provider enrollment.

• Keep track of payer and patient communications to ensure timely resolutions.

• Act as the billing and insurance subject matter expert for the Patient Experience team.

• Analyze root causes of denials, claim holds, and billing misunderstandings while suggesting process enhancements.

• Engage in the testing and implementation of AI-assisted claim management and patient communication tools.

• Assist with special projects related to claims, patient support, internal tools, and partnerships.

⛳️ Requirements

• 2–3+ years of experience in medical billing and revenue cycle operations, preferably within a telehealth or rapidly growing healthcare setting.

• 2–3+ years of managing patient and insurance accounts receivable.

• Practical experience with billing platforms like Athena, including troubleshooting claims and providing patient support.

• Strong knowledge of healthcare reimbursement methodologies and coding standards (CPT, ICD-10, HCPCS).

• Experience working remotely in a dynamic, deadline-driven atmosphere.

• Exceptional written and verbal communication abilities with a customer-focused mindset.

• Strong organizational skills, enabling the management of multiple priorities independently.

• All candidates must be authorized to work in the United States without current or future sponsorship requirements.

🏝️ Benefits

• No company benefits included for this 1099 independent contractor role.