Analysis Skills, Best Practices, Billing, Billing Records, Biology, Charge Capture, Claims Processing, Content Management Systems (CMS), Detail Oriented, Documentation, Healthcare, Identify Issues, Leadership, Medical Record System, Medicare, Operational Improvement, Operational Strategy, Problem Solving Skills, Process Improvement, Professional Services, Reimbursement, Root Cause Analysis, Standard Operating Procedures (SOP), Telehealth, Time Management, Training/Teaching, Trend Analysis, User Interface/Experience (UI/UX)
Position Summary
The Revenue Cycle Specialist will own the end-to-end encounter and claims workflow, ensuring accurate charge capture, clean claim submission, and timely resolution of billing issues.
This individual will not only work claims but also identify trends, recurring issues, and workflow improvements that can help strengthen billing operations and provider education.
Responsibilities
- Review clinical encounters for accurate and complete charge capture
- Submit professional claims and ensure clean claim processing
- Resolve claim edits, rejections, and front-end denials
- Investigate billing issues and identify root causes
- Monitor payer-specific requirements and reimbursement trends
- Document recurring billing challenges and recommend process improvements
- Assist in developing revenue cycle workflows, SOPs, and best practices
- Partner with internal teams to improve provider documentation and billing accuracy
- Support ongoing optimization of billing and revenue cycle operations
Qualifications
- 3+ years of physician or professional billing experience
- Strong experience with Medicare and Medicare Advantage claims
- Experience working with CMS-1500 professional claims
- Understanding of claim edits, denials, rejections, and revenue cycle workflows
- Ability to work independently in a remote environment
- Strong analytical and problem-solving skills
- Detail-oriented with excellent documentation abilities
Preferred Qualifications
- Telehealth billing experience, including:
- Experience working with EHR and clearinghouse systems
- Familiarity with Elation and/or Candid (training provided)
- CPB (Certified Professional Biller) certification
- CRCR (Certified Revenue Cycle Representative) certification
Ideal Candidate
The ideal candidate is naturally curious and analytical, someone who asks, "Why did this claim fail?" rather than simply correcting the issue and moving on. You enjoy identifying patterns, improving processes, and helping organizations build more efficient revenue cycle operations.
Why Join Us?
- Fully remote opportunity
- Flexible 1099 engagement with full-time hours
- Opportunity to help build and improve revenue cycle operations from the ground up
- Direct visibility with leadership
- Potential path to a long-term permanent role
- Meaningful impact within a rapidly growing national healthcare organization
Career Management Group is a boutique staffing partner focused on meaningful placements across healthcare, life sciences, technology, professional services, and more. Every role we represent is carefully vetted and client-approved — our goal is to match you with an opportunity where you can truly thrive.