Revenue Cycle Specialist in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Revenue Cycle Specialist in United States.

This role offers the opportunity to work at the forefront of modern mental healthcare operations, supporting innovative psychiatry practices through advanced revenue cycle management. You will play a critical role in improving cash flow performance, resolving complex billing challenges, and supporting providers delivering cutting-edge psychiatric treatments. The position combines hands-on accounts receivable expertise with prior authorization knowledge in a fast-moving, technology-driven environment. You’ll work closely with providers, payers, and internal teams to troubleshoot denials, optimize reimbursement processes, and improve operational workflows. Success in this role requires strong analytical thinking, adaptability, and comfort navigating evolving payer policies and healthcare billing complexities. The environment is collaborative, mission-driven, and highly focused on operational excellence, innovation, and continuous improvement. This is an ideal opportunity for someone energized by ownership, problem-solving, and meaningful impact in healthcare delivery.

Manage critical revenue cycle operations with a strong focus on claims resolution, denial management, and provider collaboration, including:

• Overseeing accounts receivable follow-up across aging buckets to maximize collections and improve cash flow performance
• Resolving denials, rejections, claim holds, and billing discrepancies while identifying root causes and preventing recurring issues
• Partnering directly with providers and clinic teams to gather supporting documentation, clarify billing issues, and improve reimbursement outcomes
• Managing clean claim submission workflows and addressing edits or bottlenecks impacting timely reimbursement
• Supporting prior authorization workflows when needed, including payer communication, benefit routing, and escalation coordination
• Navigating complex medical billing scenarios involving telehealth services, E&M coding, modifiers, and payer-specific reimbursement policies
• Auditing AR backlogs and identifying opportunities to improve workflows, SOPs, templates, and operational efficiency
• Maintaining proactive and professional communication with both external practices and internal stakeholders
• Leveraging AI-powered tools and modern healthcare technology platforms to improve productivity, accuracy, and operational scalability

Candidates should bring strong healthcare revenue cycle expertise, payer knowledge, and adaptability within modern, technology-enabled environments, including:

• 3+ years of hands-on experience in accounts receivable resolution, denial management, appeals, and healthcare billing operations
• Prior authorization experience, including payer submissions, amendments, follow-up, and resolution management
• Strong understanding of medical vs. pharmacy benefits, PBMs, specialty pharmacy workflows, and buy-and-bill processes
• Working knowledge of E&M coding, POS rules, telehealth billing, modifiers, and payer reimbursement policies
• Experience using major payer portals such as Availity, Navinet, PayerCompass, or similar systems
• Strong technical adaptability with the ability to quickly learn new software platforms and workflows independently
• Familiarity with AI tools such as Claude, Gemini, or similar productivity technologies integrated into day-to-day work
• Excellent written and verbal communication skills with strong organizational and problem-solving abilities
• Ability to thrive in fast-paced, evolving startup or scale-up environments with a proactive and ownership-driven mindset
• U.S.-based work authorization without current or future sponsorship requirements

Preferred qualifications include:

• Experience in specialty billing areas such as interventional psychiatry, oncology, infusion, immunology, or other high-cost treatment environments
• Familiarity with platforms such as CoverMyMeds, Spravato withMe, Candid Health, Notion, Slack, or Pylon
• Previous startup or high-growth company experience

• Fully remote, full-time W-2 position available anywhere within the United States
• Opportunity to work in a mission-driven organization focused on advancing mental healthcare innovation
• Exposure to cutting-edge healthcare technology and AI-enabled operational tools
• Collaborative, fast-paced environment with high ownership and growth opportunities
• Ability to contribute directly to operational improvements and scalable healthcare delivery processes
• Work alongside providers and teams advancing innovative psychiatric treatment models
• Career growth opportunities within a rapidly evolving healthcare technology environment