[Hiring] Revenue Cycle Specialist @Somewhere

Role Description

This role exists to stabilize and improve the revenue cycle of a newly acquired billing operation. You will own accounts receivable and denials day to day, drive recovery on aging and underpaid claims, and help stand up the metrics that give leadership visibility into performance. This is a hands-on role with real ownership — ideal for someone who can work independently, spot root causes, and turn messy AR into a clean, measurable process.

Key Responsibilities

• Accounts Receivable Management
  • Manage AR across hospital-based physician practices, prioritizing aging and high-value claims
  • Conduct payer follow-up via portals and calls to resolve unpaid and underpaid claims
  • Reduce days in AR and improve overall collection performance
• Denial & Exception Management
  • Identify, research, and resolve claim denials and exceptions, tracking root causes by payer and reason code
  • Prepare and submit corrected claims and appeals with appropriate documentation
  • Flag recurring denial patterns and recommend upstream process fixes
• Revenue Recovery
  • Pursue recovery on stale, denied, and underpaid claims
  • Reconcile expected vs. actual reimbursement and escalate payer discrepancies
• Metrics, Reporting & Process
  • Help establish and track core RCM metrics: clean claim/pass rate, aging AR, collection rate, DSO
  • Build and maintain reporting that gives leadership visibility into revenue cycle health
  • Contribute to SOPs and workflow improvements during the post-acquisition transition

Qualifications

• Fluent English, written and spoken — clear, confident communication with U.S. stakeholders (hard requirement)
• 5+ years in Revenue Cycle Management for U.S. hospital-based or physician practices
• Hands-on experience across AR, denial/exception management, and revenue recovery
• Working knowledge of RCM KPIs (clean claim rate, aging AR, collection rate, DSO)
• Professional-fee billing experience (CMS-1500 / 837P)
• Strong payer follow-up and appeals experience
• Reliable EST coverage, secure home office, HIPAA awareness

Preferred Qualifications

• Hands-on experience with Encoda (Claims Manager, Exception Manager, Maestro Analytics)
• Experience with athenahealth and/or Greenway (Intergy, Prime Suite) practice management systems
• Specialty exposure in anesthesia, critical care, surgery, or pulmonology billing
• Experience building or maintaining KPI dashboards / AR reporting (Excel)
• Experience supporting a system migration or company acquisition/transition

Ideal Candidate Profile

You are highly organized, analytical, and self-directed. You can work through ambiguity without hand-holding, you think in root causes rather than one-off fixes, and you're comfortable owning both the daily queue work and the reporting that sits on top of it. You communicate fluidly with U.S. teams and take pride in turning disorganized AR into a clean, measurable operation.