Leading high-level claim follow-up and appeals
Researching and resolving nuanced billing denials
Collaborating with internal billing and RCM teams
Working within payer portals to manage denials and submit appeals
Identifying denial trends and recommending process improvements
Manage complex aged AR and escalated denials
Prepare and submit thorough appeals with supporting documentation
Independently navigate payer rules across Medicare, Medicaid, and commercial plans
Educate patients on billing issues and payment options
Track patterns in payer denials and suggest systemic improvements
Validate denial coding accuracy and appeal when necessary
Escalate exhausted appeal efforts using internal escalation pathways

Education: A college degree is preferred, but not required. We’re looking for sharp, capable people who can think critically and learn quickly.
Experience:
2–3+ years in healthcare AR or denial management, with deep knowledge of CPT/ICD-10, UB04, and CMS 1500 forms
Direct experience with reimbursement patterns, coding nuances, or appeals strategy in physical therapy, occupational therapy, speech therapy, or ABA
Excellent communication, organization, and multitasking abilities
Strong problem-solving skills and ability to work independently
Tech-savvy with advanced experience in payer websites and portals
Ability to manage confidential information with discretion.

Medical, Dental, Vision, Life & AD&D, Short
and Long-Term Disability (coverage begins on Day 1)
Simple IRA with 3% company match (eligible after 1 year)
Paid Time Off:
14 days PTO annually
6 company holidays + 1 floating holiday
Flexible schedule, with a shared rhythm during standard business hours (Monday–Friday, 9:00 AM to 5:00 PM ET). We trust you to manage your time — and we expect everyone to stay connected, responsive, and aligned.

RCM Billing Specialist

Key skills