Revenue Cycle Management (RCM) Specialist

Total Life, Inc.

21d • $50,000 - $70,000 • Remote

About The Position

The RCM Specialist is a mid-level role responsible for the tactical execution and oversight of the patient financial lifecycle. You will ensure that our mission remains sustainable by managing the end-to-end billing process. This role requires a deep understanding of the U.S. healthcare industry, specifically regarding Medicare and commercial payers, to ensure our senior clients receive seamless access to care without financial friction.

Requirements

• Minimum of 3–5 years of experience in medical billing or revenue cycle operations within the U.S. healthcare industry.
• Strong proficiency in Medicare (Parts A, B, C, and D), Medigap, and major commercial payers (e.g., Humana, UnitedHealthcare).
• Solid working knowledge of CPT, ICD-10, and HCPCS coding methodologies.
• Experience navigating Electronic Health Records (EHR) and practice management systems (e.g., Healthy, Athena, or similar).
• Exceptional attention to detail with the ability to reconcile accounts and solve complex billing discrepancies.
• Excellent verbal and written skills, with the ability to explain complex financial terms to a senior population.

Responsibilities

• Perform accurate charge entry, claim submission, and payment posting to ensure timely revenue capture.
• Manage insurance eligibility verification and authorizations, specifically navigating the complexities of Medicare and supplemental plans.
• Identify, investigate, and resolve claim rejections and underpayments by filing effective appeals with U.S. insurance carriers.
• Monitor accounts receivable (A/R) aging reports, identify payment trends, and resolve outstanding balances.
• Handle billing inquiries from seniors and their families with empathy, providing clarity on account balances and payment plans.
• Maintain strict adherence to HIPAA, CMS billing requirements, and state/federal healthcare regulations.
• Generate and analyze reports on collections and denial rates to identify "revenue leaks" and suggest process improvements.
• Collaborate with clinical and operations teams to ensure sessions are documented correctly for billing

Benefits

• Competitive compensation and benefits package.
• The ability to influence the financial health of a movement dedicated to the mental wellness of the 65+ population.
• Premium Medical, Dental, and Vision insurance plans for you and your dependents.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed