This is a remote position.

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  Contract type: Independent Contractor
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  Night Shift Schedule:
  Monday to Thursday - 8:45am to 5pm New York Time (8:45pm - 5am Manila Time)
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  Friday - 8:45am to 3:45pm New York Time (8:45pm - 3:45am Manila Time)

Role Summary

The Revenue Cycle Specialist is responsible for managing the full revenue cycle process, from provider enrollment and prior authorizations through claims submission, reimbursement, and follow-up. This role ensures timely, accurate billing and payment while identifying and resolving issues that impact cash flow.

Description:

Provider Enrollment

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  Manage provider enrollments and re-credentialing with commercial and government payers

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  Track enrollment status and follow up with payers as needed

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  Maintain accurate provider and payer records

Prior Authorizations

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  Obtain prior authorizations based on payer requirements

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  Verify eligibility and benefits prior to services

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  Communicate authorization approvals, denials, and requirements to internal teams

Claims Submission & Billing

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  Review claims for accuracy and completeness prior to submission

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  Submit electronic and paper claims using billing software

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  Audit documentation to ensure services billed are supported

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  Address and correct rejected claims in a timely manner

AR / Reimbursement / Follow-Up

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  Post payments, ERAs, and EOBs accurately

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  Follow up on unpaid, underpaid, and no-response claims

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  Investigate and resolve denials, including resubmissions and appeals

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  Track outstanding balances and identify trends impacting reimbursement

Reporting & Collaboration

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  Identify recurring issues and recommend process improvements

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  Provide regular updates on AR status, denials, and enrollment issues

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  Attend team meetings and complete assigned follow-ups

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  Strong attention to detail and organizational skills.
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  Ability to plan, prioritize, and meet deadlines in a fast-paced environment.
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  Advanced reading comprehension and ability to synthesize complex data into actionable processes.
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  Willingness to learn, grow, and adapt to evolving processes.
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  Genuine commitment to client success, beyond task completion. Focuses on driving results that add optimum value, not just checking boxes.
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  Excellent communication skills—both written and verbal—with clarity and conciseness.
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  Collaborative team player
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  Demonstrates initiative and accountability to achieve high-quality results.
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  Demonstrates persistence and professionalism in working with payors to achieve effective outcomes.

Requirements

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  2-year college degree
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  2 years related experience
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  Experience with Smartsheet, Outlook, and other cloud-based project management or tracking tools preferred
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  US Healthcare experience a plus but not required

Benefits