Revenue Cycle Management Specialist

 Posted 11 hours ago
     
2-5 years experience
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AI Summary

Manage the financial lifecycle of patient care, including accurate billing, claims processing, and payment posting. Handle patient billing inquiries, resolve insurance denials, and generate performance reports to optimize reimbursement.


 

Job Title: Revenue Cycle Specialist 

Department: 2500 – Revenue Cycle Management 

Reports to: Director of Revenue Cycle 

 

Job Summary: 

The Revenue Cycle Specialist is responsible for the management of the financial lifecycle of patient care, ensuring accurate billing, timely claims processing, and timely reimbursement for services. 

Job Location: Remote

Supervisory Responsibilities: 

  •  None 

 Duties/Responsibilities: 

Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions. 

 Cash Applications 

  • Posts payments, adjustments, and denials from all payers and patients. 
  • Ensures all transactions are recorded promptly and accurately in accordance with internal accounting policies. 
  • Identifies and payments not being paid at the allowed/contracted amount and communicates this to the Director. 
  • Process demographic, tax, banking (EFT) updates in a timely manner. 
  • Audit insurance and patient accounts to determine if refund is needed, and process refunds if appropriate. 

Correspondence 

  • Downloads and distributes all correspondence, EOB’s, and ERA’s as received from all sources (Mail, Payer Portals, Banking Lockbox, Fax, Email). 

Patient Relationships 

  • Manage patient billing inquiries, set up payment plans, and follow up on outstanding balances. 
  • Engage directly with patients to explain their bills, resolve billing inquiries, and establish payment for outstanding balances, ensuring a positive patient experience. 
  • Generate monthly patient statements. 

Billing and Collections 

  • Prepare and correct claims to cleanly pass from the EMR to clearinghouse. 
  • Perform posting of charges and completion of claims to payers in a timely manner. 
  • Resolve patient accounts through the correction of billing edits and clearinghouse rejections. 
  • Navigate portals to send claims for adjudication. 
  • Prepare invoices to send to third party payers. 

Reporting and Analysis 

  • Generate reports on revenue cycle performance to identify trends in payments, denials, and accounts receivable. 

Cross Functional Support 

  • Partner with all internal and external RCM teams to ensure seamless integration and operations of revenue cycle functions. 

Perform other duties as assigned by the Billing Director, contributing to special projects, process improvements, and operational readiness. 

Required Skills/Abilities:  

  • High school diploma or equivalent required; associate or bachelor’s degree preferred. 
  • Two or more years of medical billing experience. 
  • Excellent attention to detail, organizational skills, and ability to manage deadlines. 
  • Proficiency with Microsoft Office applications. 
  • Strong analytical and problem-solving skills. 
  • Clear professional written and verbal communication. 
  • Ability to interpret payer and regulatory requirements. 
  • Effective time management and prioritization. 
  • Collaborative and service-oriented mindset. 

 Physical Requirements:  

  • Ability to sit for extended periods and use a computer and phone regularly. 
  • Ability to manage multiple priorities in a fast-paced environment. 
  • Occasional overtime may be required to meet operational deadlines. 
  • Ability to work in a remote environment 

 Other duties 

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. 

 Why Join Us? 

Arete Health is a growing, patient-centric outpatient physical therapy provider focused on excellence in clinical outcomes, team culture, and operational performance. We empower our therapists and support teams to thrive in an environment that values care, integrity, and innovation. At Arete Health, we believe that leadership is about people first. You’ll play a key role in scaling a mission-driven organization that puts patients and providers at the center of everything we do. 

Arete Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.


Requirements

Required Skills/Abilities:  

  • High school diploma or equivalent required; associate or bachelor’s degree preferred. 
  • Two or more years of medical billing experience. 
  • Excellent attention to detail, organizational skills, and ability to manage deadlines. 
  • Proficiency with Microsoft Office applications. 
  • Strong analytical and problem-solving skills. 
  • Clear professional written and verbal communication. 
  • Ability to interpret payer and regulatory requirements. 
  • Effective time management and prioritization. 
  • Collaborative and service-oriented mindset. 


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