RCM Billing Specialist

Overview

This role involves joining a high-performing team as an RCM Billing Specialist focused on advanced denial resolution workflows, appeals processes, and accounts receivable (AR) strategy. The position plays a critical role in ensuring clients receive timely and accurate reimbursements within physical therapy, occupational therapy, speech therapy, and ABA practice settings.

Responsibilities

• Lead high-level claim follow-up and appeals
• Research and resolve complex billing denials
• Collaborate with internal billing and revenue cycle management teams
• Manage denials and submit appeals through payer portals
• Identify denial trends and recommend process improvements
• Manage complex aged AR and escalated denials
• Prepare and submit thorough appeals with supporting documentation
• Navigate payer rules independently across Medicare, Medicaid, and commercial plans
• Educate patients on billing issues and payment options
• Validate denial coding accuracy and appeal when necessary
• Escalate exhausted appeal efforts using internal escalation pathways

Requirements

• 2–3+ years of experience in healthcare accounts receivable or denial management
• Deep knowledge of CPT/ICD-10 coding, UB04, and CMS 1500 forms
• Direct experience with reimbursement patterns, coding nuances, or appeals strategy in physical therapy, occupational therapy, speech therapy, or ABA
• Excellent communication, organization, and multitasking skills
• Strong problem-solving abilities and capacity to work independently
• Advanced experience with payer websites and portals
• Ability to manage confidential information with discretion
• College degree preferred but not required

Preferred Qualifications

• Humble, self-aware, and respectful
• Empathetic and compassionate
• Adaptable and eager to learn
• Resourceful and effective
• Transparent and honest

Compensation & Benefits

• Full-time position
• Pay range: $42,500 – $57,500 depending on experience
• Benefits include:
  • Medical, dental, vision, life & AD&D insurance
  • Short- and long-term disability coverage starting Day 1
  • Simple IRA with 3% company match (eligible after 1 year)
  • Paid time off: 14 days annually, 7 company holidays plus 1 floating holiday
• Flexible schedule during standard business hours (Monday–Friday, 9:00 AM to 5:00 PM ET)

Location

This is a fully remote position.