Specialist, Revenue Cycle

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Specialist, Revenue Cycle based in United States.

This is a full-time remote opportunity supporting day-to-day revenue cycle operations across a growing healthcare environment. You will help ensure accurate, timely reimbursement while reducing administrative barriers that can affect patient access. The role spans eligibility and benefits verification, prior authorizations, coding support, charge entry, claims processing, and denial resolution. You will collaborate closely with clinical, patient services, finance, provider, and payer stakeholders to keep revenue cycle activities moving efficiently. As payer relationships and healthcare programs expand, you will also help identify trends and develop scalable workflows and operational resources. The position combines independent ownership of routine activities with opportunities to improve processes and resolve recurring issues. Success requires strong healthcare revenue cycle knowledge, attention to detail, sound judgment, and effective cross-functional communication.

Accountabilities:: Independently manage routine revenue cycle activities in accordance with established procedures, payer requirements, and operational controls.

Verify patient eligibility and benefits and determine the appropriate administrative steps required for coverage and reimbursement.

Manage prior authorization and referral requirements from initiation through completion, including tracking outstanding information, expiration dates, and renewals.

Review documentation for billing readiness, coordinate resolution of routine deficiencies, and ensure services are prepared for accurate charge entry.

Perform timely charge entry using documented services and established coding protocols, including CPT coding for pulmonary rehabilitation and related services.

Prepare and submit claims, monitor claim status, and research and resolve routine edits, rejections, and denials.

Communicate with insurance payers to investigate billing, authorization, reimbursement, and claim-related issues.

Coordinate with referring provider offices to obtain documentation required for authorization, billing, and patient onboarding.

Assist patients and caregivers with routine questions concerning coverage, benefits, authorization requirements, and administrative status.

Monitor revenue cycle metrics, identify recurring issues and trends, and communicate significant findings to relevant stakeholders.

Recommend practical workflow and process improvements and support the implementation of approved changes.

Develop and maintain payer-specific workflows, procedures, and operational reference materials.

Collaborate with Patient Services, clinical leadership, Finance, providers, and payer representatives to maintain accurate information flow and continuity across the revenue cycle.

Requirements:

At least 3 years of experience in healthcare revenue cycle, medical billing, patient access, healthcare operations, or a related healthcare administrative function.

Demonstrated experience independently handling multiple revenue cycle functions, such as eligibility verification, prior authorizations, charge entry, claims submission, claim follow-up, or denial resolution.

Experience using electronic medical records, practice management platforms, or healthcare billing systems.

Experience researching and resolving routine payer, billing, authorization, and reimbursement issues.

Working knowledge of healthcare revenue cycle processes, medical terminology, medical billing practices, and CPT and ICD-10 coding concepts.

Strong analytical and problem-solving abilities, with the capacity to research issues and determine appropriate next steps.

Excellent attention to detail and the ability to independently manage competing priorities, follow-ups, and deadlines.

Sound judgment, including the ability to recognize when clinical, contractual, compliance, policy, or leadership escalation is appropriate.

Strong written and verbal communication skills and the ability to collaborate with clinical, operational, financial, patient, provider, and payer stakeholders.

Proficiency with Microsoft Office and web-based healthcare applications.

Preferred qualifications include an Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, Health Information Management, or a related discipline.

AAPC Certified Professional Coder (CPC) certification is preferred.

Experience with Athenahealth, commercial insurance plans, Medicare, insurance verification, or prior authorization processes is advantageous.

Experience in pulmonary rehabilitation, cardiopulmonary medicine, rehabilitation, or outpatient specialty care is a plus.

Benefits:

Hourly compensation range of $19.65–$33.50 , with actual compensation determined by qualifications, experience, education, certifications, geographic location, market factors, and internal equity.

Full-time remote work environment.

Medical coverage with HMO and POS plan options; employee-only coverage is 100% employer-paid for eligible full-time employees.

Dental and vision insurance, including preventive dental care, orthodontia benefits, annual eye exams, eyewear and contact lens allowances, and vision discounts.

Health Care and Dependent Care Flexible Spending Accounts.

Employer-provided short-term and long-term disability coverage.

401(k) retirement savings plan with investment options and retirement planning resources.

Paid time off and company-paid holidays.

Employee Assistance Program providing confidential emotional health, work-life, legal, financial, childcare, eldercare, and wellness resources.

Voluntary supplemental coverage, including accident, critical illness, and hospital indemnity insurance.

Dedicated benefits support through benefits advisors.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether?    Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.     #LI-CL1