Revenue Cycle Management Specialist

Autism Diagnosis Group•,

3d•$700 - $2,000•Remote

About The Position

We are looking for a detail-obsessed Revenue Cycle Management Specialist to own the full claims lifecycle – from claim submission and scrubbing to payment posting, AR follow-up, and denial resolution. You will ensure that every claim is submitted accurately, every denial is challenged, and every payment is reconciled. This is not a passive billing role. You will be the person who catches errors before claims go out, follows up relentlessly on unpaid claims, and identifies patterns that prevent denials from happening in the first place. If you hate leaving money on the table and enjoy the puzzle of resolving claim discrepancies, you will thrive here.

Requirements

2+ years of experience in medical billing, AR follow-up, claims processing, or revenue cycle operations
Knowledge of CPT, HCPCS, and ICD-10 coding
Experience with claim clearinghouses and payer portals
Experienced with CMS 1500 forms
Expert knowledge of Google Sheets/Excel to create their own reporting & analysis
Strong attention to detail – you catch errors before they become rejections
Ability to manage multiple claims and deadlines simultaneously
Familiarity with Availity and other payer portals
Proactive follow-through – you don't wait for payers to respond; you call them
Excellent written and spoken English communication skills
Reliable remote work setup with backup power and internet (EST hours)

Nice To Haves

Experience in behavioral health, ABA, or therapy billing
Experience with multi-state billing and payer enrollment
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification
Experience in a startup or fast-growing healthcare organization
Associate's or Bachelor's degree in healthcare administration, business, or related field

Responsibilities

Prepare, review, and submit accurate claims to commercial payers (e.g., Aetna, Cigna, Blue Cross Blue Shield, UnitedHealthcare, Optum)
Verify and ensure the accuracy of billing codes (CPT, HCPCS, ICD-10) and modifiers for services rendered, with a focus on behavioral health and virtual care codes
Scrub claims for errors in demographics, eligibility, authorization, coding completeness, and payer-specific requirements before submission
Maintain up-to-date knowledge of commercial insurance billing requirements, with a focus on behavioral health and telehealth regulations
Use billing software and clearinghouses to process and track claims
Ensure timely filing requirements are met for all assigned payers
Monitor claim status and follow up on unpaid, underpaid, and denied claims promptly
Investigate and resolve claim discrepancies, denials, and appeals
Submit corrected claims and appeals when necessary
Maintain AR aging across assigned payer relationships – work buckets by age and priority
Review EOBs and denial trends to identify recurring issues and root causes
Generate reports for outstanding accounts receivable and payment trends
Post insurance and patient payments accurately (manual and electronic)
Reconcile ERA/EOB payments against expected reimbursement
Identify and resolve underpayments, overpayments, and credit balances
Process refunds to insurance and patients in compliance with regulations
Ensure all billing practices comply with federal, state, and local regulations
Verify patient insurance information, eligibility, and prior authorization requirements
Maintain accurate records of billing activities and patient accounts
Follow HIPAA regulations to ensure patient confidentiality
Support internal audits and quality reviews as requested
Collaborate with office staff, clinical teams, and payers to address billing and reimbursement issues
Proactive about providing feedback to benefits verification team to ensure upfront accurate patient out of pocket estimates
Provide clear communication to patients regarding their billing, payments, and financial responsibilities
Respond to inquiries from payers, patients, and colleagues in a professional and timely manner
Flag recurring pre-submission error patterns with recommendations for upstream fixes