Revenue Cycle Specialist — AR, Denials & Revenue Recovery

Location & Employment
Remote. Reliable coverage of U.S. Eastern (EST) business hours is required. Candidates in the Americas preferred; the Philippines will be considered for the right experience. Full-time.

About the Company
We are a rapidly growing U.S.-based revenue cycle organization expanding through the acquisition of a specialized medical billing company that serves hospital-based physician practices — including anesthesia, critical care, surgery, and pulmonology groups. As we integrate this new operation, we are building a lean, high-accountability team to strengthen collections, tighten denial management, and bring clear reporting to the business.

About the Role
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

Required 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.

Revenue Cycle Specialist — AR, Denials & Revenue Recovery - 21500