Medical Billing Specialist

ABOUT THIS ROLE

We are an AI company building revenue cycle management tools for US hospitals, physician groups, and ambulatory surgery centres. Our AI handles charge capture validation, claim scrubbing, denial categorisation, and AR prioritisation — the same functions that RCM teams at health systems and BPOs manage every day. We need people who have personally worked the revenue cycle at a US provider or healthcare BPO and can tell us from real experience where the AI decisions are right and where they break down.

WORKFLOWS COVERED

• Charge capture and charge entry — CDM maintenance, charge lag management, coding compliance
• Claim scrubbing and clearinghouse submission — 837P, 837I, payer-specific edits
• Denial management — root cause analysis, denial trends, appeal writing, and resubmission
• Accounts receivable follow-up — payer-specific AR, aging buckets, write-offs, and collections
• Payment posting and ERA reconciliation

WHAT YOU WILL DO

• Share how revenue cycle management works in practice across the full billing cycle — from charge capture and claim submission through denial management, AR follow-up, and payment reconciliation
• Review RCM process descriptions, denial categorisation logic, or AR prioritisation outputs and tell us where they miss what a real revenue cycle professional would flag
• Help us understand payer-specific behaviour — denial patterns, timely filing rules, underpayment trends — from someone who has worked these queues in a live US provider or BPO environment
• Advise on what effective revenue cycle operations look like and where common errors or inefficiencies occur across the billing-to-collection cycle

YOU ARE THE RIGHT FIT IF

• Minimum 4 years in US healthcare revenue cycle with strong experience in at least two major RCM functions — billing, denials, AR, or payment posting
• Have personally worked denials, submitted appeals, or managed AR aging — not just run reports or managed a team
• Know your coding — ICD-10-CM, CPT, HCPCS Level II — and how it applies in a billing context, not just abstractly
• Worked at a hospital system, physician management company, or a healthcare BPO such as Optum, Conifer, Ensemble, R1 RCM, or Waystar (formerly nThrive)

NICE TO HAVE

• CRCS (Certified Revenue Cycle Specialist) — AAHAM
• CPC or CCS certification (AAPC/AHIMA)

***Pay - 2,000 – 3,000 per hour