[Hiring] RCM Specialist @NIVA Health

Role Description

We’re looking for an RCM Specialist who can support our day-to-day revenue cycle operation across billing, AR, denials, appeals, claim follow-up and payer-related issues. This role will work closely with our Senior RCM Lead and wider operational team to help keep claims moving, resolve issues quickly, identify recurring problems and support strong cash collection performance.

You don’t need to own the entire RCM function — but you do need to take ownership of the work in front of you.

What you’ll do

• Billing & claims support
  • Support accurate and timely claim submission.
  • Review claim issues, rejections and billing errors.
  • Follow up on outstanding claims and help resolve delays.
  • Support charge capture and claim reconciliation where needed.
  • Work with internal teams to correct documentation or billing issues.
• AR & collections
  • Work assigned AR and prioritize accounts based on aging, value and payer requirements.
  • Follow up with payers on unpaid or underpaid claims.
  • Identify payment delays, underpayments and recurring payer issues.
  • Maintain clear notes and follow-through on outstanding accounts.
  • Support collection targets and AR reduction goals.
• Denials & appeals
  • Review denied claims and determine the reason for denial.
  • Prepare and submit appeals or corrected claims where appropriate.
  • Track recurring denial trends and escalate patterns to the Senior RCM Lead.
  • Help ensure corrective actions are followed through.
  • Support timely filing and payer-specific requirements.
• Payer & insurance support
  • Work with Medicare, Medicaid and commercial payer processes.
  • Research payer policies and claim requirements.
  • Follow up on authorization, eligibility or coverage-related issues where required.
  • Escalate complex payer issues appropriately.
• Reporting & quality
  • Maintain accurate worklists and reporting.
  • Track assigned KPIs such as AR aging, denial volume, claim status and productivity.
  • Flag risks or recurring problems rather than allowing them to repeat.
  • Support audits, reconciliations and process improvement work.

Qualifications

• 3+ years of US healthcare RCM or medical billing experience.
• Hands-on experience with AR follow-up, denials, appeals and billing.
• Experience working with US payers.
• Working knowledge of ICD-10, CPT and HCPCS.
• Familiarity with Medicare, Medicaid and commercial insurance.
• Good understanding of claim lifecycle and payer follow-up.
• Strong attention to detail and documentation.
• Confidence working independently while knowing when to escalate.
• Good communication and problem-solving skills.
• Experience working toward productivity, quality and collection KPIs.
• Experience with EHR, practice management or billing systems is preferred.
• Certifications such as CPC, CRCR or CCS are helpful, but not required.

The person we’re looking for

You’re someone who likes solving problems. When a claim is denied, you don’t just move it to another queue. You want to understand:

• Why was it denied?
• What needs to be corrected?
• Can it be recovered?
• Is this happening repeatedly?

You’re comfortable working through detail, following up consistently and making sure issues don’t get lost. You also know when something is bigger than one claim and needs to be escalated.

Why this role matters

Our RCM team is growing, and this role will be an important part of supporting the Senior RCM Lead and keeping the operation running effectively. You’ll work across billing, AR, denials and payer follow-up while building deeper experience across the full revenue cycle. If you’re looking for a role where you can strengthen your RCM expertise, take real ownership of your work and grow within a developing team, we’d like to hear from you.