Revenue Cycle Management Specialist

REVENUE CYCLE MANAGEMENT SPECIALIST

Job Title: Revenue Cycle Management Specialist (Non-US)
Location: 100% Remote (Offshore)
Employment Type: Full-Time Contractor
Compensation: $700-$2,000 
Hours: 40 hours/week, primarily EST business hours
Reports to: Operations / Revenue Cycle Lead

About Josi Health
Josi Health is a fast-growing remote healthcare company focused on making neurodivergent care (including evaluations & therapy) more accessible, faster, and less stressful for families. We operate across 40+ states and work with major insurance carriers. Every claim we submit correctly means another family gets care without billing delays.

About the Role
We are looking for a detail-obsessed Revenue Cycle Management Specialist to own the full claims lifecycle – from claim submission and scrubbing to payment posting, AR follow-up, and denial resolution. You will ensure that every claim is submitted accurately, every denial is challenged, and every payment is reconciled.

This is not a passive billing role. You will be the person who catches errors before claims go out, follows up relentlessly on unpaid claims, and identifies patterns that prevent denials from happening in the first place. If you hate leaving money on the table and enjoy the puzzle of resolving claim discrepancies, you will thrive here.

Key Responsibilities

Billing and Claims Submission
- Prepare, review, and submit accurate claims to commercial payers (e.g., Aetna, Cigna, Blue Cross Blue Shield, UnitedHealthcare, Optum)
- Verify and ensure the accuracy of billing codes (CPT, HCPCS, ICD-10) and modifiers for services rendered, with a focus on behavioral health and virtual care codes
- Scrub claims for errors in demographics, eligibility, authorization, coding completeness, and payer-specific requirements before submission
- Maintain up-to-date knowledge of commercial insurance billing requirements, with a focus on behavioral health and telehealth regulations
- Use billing software and clearinghouses to process and track claims
- Ensure timely filing requirements are met for all assigned payers

Accounts Receivable Management
- Monitor claim status and follow up on unpaid, underpaid, and denied claims promptly
- Investigate and resolve claim discrepancies, denials, and appeals
- Submit corrected claims and appeals when necessary
- Maintain AR aging across assigned payer relationships – work buckets by age and priority
- Review EOBs and denial trends to identify recurring issues and root causes
- Generate reports for outstanding accounts receivable and payment trends

Payment Posting and Reconciliation
- Post insurance and patient payments accurately (manual and electronic)
- Reconcile ERA/EOB payments against expected reimbursement
- Identify and resolve underpayments, overpayments, and credit balances
- Process refunds to insurance and patients in compliance with regulations

Compliance and Documentation
- Ensure all billing practices comply with federal, state, and local regulations
- Verify patient insurance information, eligibility, and prior authorization requirements
- Maintain accurate records of billing activities and patient accounts
- Follow HIPAA regulations to ensure patient confidentiality
- Support internal audits and quality reviews as requested

Communication and Coordination
- Collaborate with office staff, clinical teams, and payers to address billing and reimbursement issues
- Proactive about providing feedback to benefits verification team to ensure upfront accurate patient out of pocket estimates
- Provide clear communication to patients regarding their billing, payments, and financial responsibilities
- Respond to inquiries from payers, patients, and colleagues in a professional and timely manner
- Flag recurring pre-submission error patterns with recommendations for upstream fixes

What We're Looking For

Must-Have
- 2+ years of experience in medical billing, AR follow-up, claims processing, or revenue cycle operations
- Knowledge of CPT, HCPCS, and ICD-10 coding
- Experience with claim clearinghouses and payer portals
- Experienced with CMS 1500 forms
- Expert knowledge of Google Sheets/Excel to create their own reporting & analysis
- Strong attention to detail – you catch errors before they become rejections
- Ability to manage multiple claims and deadlines simultaneously
- Familiarity with Availity and other payer portals
- Proactive follow-through – you don't wait for payers to respond; you call them
- Excellent written and spoken English communication skills
- Reliable remote work setup with backup power and internet (EST hours)

Preferred (Not Required)
- Experience in behavioral health, ABA, or therapy billing
- Experience with multi-state billing and payer enrollment
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification
- Experience in a startup or fast-growing healthcare organization
- Associate's or Bachelor's degree in healthcare administration, business, or related field

What We Offer
- Fully remote – work from anywhere outside the US
- Competitive monthly compensation in USD
- Ownership of a critical function with direct impact on revenue
- Autonomy – we trust you to own your deadlines
- Supportive, collaborative team culture

How to Apply
1. Upload your resume (PDF)
2. Complete the short questionnaire
3. Submit