revenue cycle specialist

NanoNets

Nanonets is transforming the way Revenue Cycle works. Our AI platform takes the manual, messy, time consuming work &mdash; that bogs down Healthcare &mdash; and turns it into seamless, automated processes. What once took hours of human effort now takes seconds with Nanonets. Our client footprint spans across 100s of providers. In 2024, we raised a $29M Series B led by Accel with continued backing from Elevation Capital and YCombinator, fueling our mission to reshape entire industries through intelligent automation. With revenues tripling year over year and a rapidly scaling global team, we&rsquo;re not just imagining the future of work &mdash; we&rsquo;re building it.The RoleNanonets is seeking a Senior Revenue Cycle Specialist to join our fast-growing Healthcare business &mdash; a team focused on transforming U.S. healthcare operations with AI-powered automation. In this role, you&rsquo;ll bring deep domain expertise in medical billing, payments, coding, and denials to help shape and scale how Nanonets supports healthcare providers and billing organizations.You&rsquo;ll act as a subject matter expert (SME) and hands-on operator, ensuring that our automation solutions map seamlessly to real-world RCM workflows. This is a unique opportunity to join a fast-moving startup environment, collaborate with product and engineering, and directly influence how technology modernizes the revenue cycle.Roles and Responsibilities <ul><li>Own and optimize end-to-end revenue cycle processes across billing, payments, medical coding, claims, and denials management.</li><li>Serve as the internal RCM expert for customer-facing teams (Sales, Implementation, Product), ensuring solutions align with provider workflows.</li><li>Review and analyze billing data to identify automation opportunities and process improvements.</li><li>Partner with Sales and Implementation teams to guide customers on best practices and ensure operational success post-deployment.</li><li>Document workflows, edge cases, and billing nuances to inform product roadmap and customer enablement materials.</li><li>Stay up-to-date on payer regulations, coding updates, and healthcare billing trends to keep Nanonets&rsquo; offerings compliant and relevant.</li><li>Collaborate cross-functionally in a fast-paced environment where processes are still being built and iterated on.</li></ul>Requirements and Skills <ul><li>6+ years of experience in healthcare revenue cycle management, preferably within a provider, billing services, or healthcare technology organization.</li><li>Deep understanding of billing workflows, payment posting, medical coding, and denials management.</li><li>Familiarity with electronic health record (EHR) or practice management systems used in healthcare billing.</li><li>Strong analytical and process improvement skills &mdash; ability to identify workflow gaps and propose scalable solutions.</li><li>Excellent communication and collaboration skills with both technical and non-technical stakeholders.</li><li>Comfortable working independently in a fast-paced, startup-style environment with evolving processes.</li></ul>Nice to Have <ul><li>Experience partnering with product or engineering teams on workflow automation or system integrations.</li><li>Familiarity with AI-driven automation, document processing, or healthcare technology platforms.</li><li>Certification in Medical Billing/Coding (e.g., CPC, CPB, or CMRS).</li></ul>Additional Information <ul><li>Hybrid role (twice a week in our Palo Alto or Seattle office), based in the Bay Area, CA or Seattle, WA</li><li>Base salary: $90k - $120k</li></ul>Ready to apply? Follow this link to submit your application: https://job-boards.greenhouse.io/nanonets/jobs/4957982008Job Type: Full-timePay: $90,000.00 - $120,000.00 per yearBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible schedule</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Parental leave</li><li>Retirement plan</li><li>Vision insurance</li></ul>People with a criminal record are encouraged to applyWork Location: In person

Senior Revenue Cycle Specialist

Christus Health

Description POSITION SUMMARY: Responsible for performing billing, collections and reimbursement services of claims and duties of the hospital business office. In doing so, ensures that all claims billed and collected meet all government-mandated procedures for Integrity and Compliance. Requirements EDUCATION: HS Diploma or equivalency requiredCERTIFICATION/LICENSES: None requiredSKILLS: <ul><li>Must have good verbal and written communication skills in order to present and explain information to internal and external customers</li><li>Ability to write letters using proper English, grammar, spelling, vocabulary, and punctuation</li><li>Must have practical experience with Adobe, Word, Excel and Microsoft Outlook applications. Also, any other computer applications related to the work (document imaging systems, Organizational Share Point, Revenue Cycle systems) </li><li>Must have ability to make independent decisions that are generally guided by established procedures.</li><li>Must have a desire to learn ethical and compliant business practices. </li><li>Must be able to handle sensitive, stressful and confidential situations and account information. </li><li>Must have excellent keyboarding and 10-key skill-set.</li><li>Must have knowledge to perform functions requiring the use of the Internet.</li><li>Willingness and ability to learn new task.</li><li>Understanding of alternative Business Office financial resources</li><li>Ability to provide information and/or recommendations related to sources of recovery</li><li>Knowledge of general hospital A/R accounts</li></ul><ul><li>GENERAL/ORGANIZATIONAL COMPETENCIES: </li></ul><ul><li>Quality/Compliance: Achieves a standard of excellence with work processes and outcomes, honoring Organizational policies and all regulatory requirements.</li><li>Customer focus: Strives for high customer satisfaction, going out of our way to be helpful and pleasant, making it as easy as possible on the patient, family member or customer rather than our department or organization.</li><li>Safety Mindset: Promptly reports or corrects any unsafe condition. Records/reports the need for service maintenance or repair of equipment and removes any faulty equipment from service.</li><li>Communication: Balances listening and talking, speaking and writing clearly and accurately, influencing others, keeping others informed.</li><li>Collegiality: Is helpful, respectful, approachable and team oriented, building strong working relationships and a positive work environment.</li><li>Initiative: Takes ownership of the work, doing what is needed without being asked, following through</li><li>Efficiency: Plans, manages time well, is on time, is cost conscious, and thinks of better ways to do things.</li><li>Coach-ability: Is receptive to feedback, demonstrates a willingness to learn, and embraces continuous improvement.</li><li>Demonstrates an ability to work in a collaborative manner. </li><li>Diversity: Acknowledges and respects cultural diversity in all interactions. </li></ul>EXPERIENCE: Two years of experience preferred in any of the following: Medicare, Medicaid and/or Commercial Insurance billing, collections, payment and reimbursement verification and/or refunds. College education in business and/or accounting may substitute for experience on a year for year basis up to two years.NATURE OF SUPERVISION: Responsible to: Manager, Business OfficeENVIRONMENT: -Bloodborne pathogen: AWorks in a clean, well-lighted smoke free environment.PHYSICAL REQUIREMENTS: Long periods of sitting, walking. Must be flexible in work schedule. Subject to stressful situations. Extended use of video display terminal and keyboard utilizing sound ergonomic principles. May be required to push, pull or lift up to 20 pounds.

HB Revenue Cycle Business Specialist II/ Patient Account Services / Full-Time

Macrise Tech Solutions

We are seeking a detail-oriented and proactive Medical Billing &amp; Collections Specialist to join our healthcare revenue cycle team. The successful candidate will be responsible for preparing accurate insurance claims, managing patient billing, maintaining precise records, and ensuring timely payment collection. This role requires strong organizational skills, attention to detail, and the ability to communicate effectively with patients, payers, and internal teams to support efficient billing operations and optimal cash flow.Key ResponsibilitiesMedical Billing<ul><li>Prepare and submit accurate insurance claims and patient invoices promptly.</li><li>Review claims for completeness, coding accuracy, and compliance with payer and regulatory requirements.</li><li>Maintain organized and current billing documentation within the practice management system.</li><li>Accurately process adjustments, credit memos, and payment postings.</li><li>Verify and update patient demographic and insurance information regularly.</li><li>Generate monthly billing statements and customized Revenue Cycle Management (RCM) reports.</li><li>Support the accounting team with reconciliations and month-end financial reporting.</li><li>Recommend and implement process improvements to enhance billing accuracy and efficiency.</li></ul>Collections<ul><li>Proactively follow up on unpaid insurance claims and patient balances to ensure timely reimbursements.</li><li>Monitor and manage Accounts Receivable (A/R) aging reports, prioritizing overdue accounts for action.</li><li>Communicate with insurance companies to resolve delays, denials, and underpayments.</li><li>Address patient billing inquiries professionally and arrange payment plans when necessary.</li><li>Collaborate with the billing and patient services teams to resolve complex collection cases.</li><li>Accurately document all collection activities, communications, and follow-ups within the system.</li></ul>Job Type: Full-timePay: Rs40,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Lahore: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Preferred)</li></ul>Work Location: In person

Medical Billing & Collections Associate

Shields Health Solutions

<div>Job Purpose:

Reporting to the Revenue Cycle Manager, the Revenue Cycle Analyst responsibilities include overseeing the pharmacy revenue cycle management functions on behalf of each partnering health system. This may encompass performing revenue cycle activities for various health system partners, working in a variety of third-party receivables platforms, and supporting management and our clients in various projects 


Job Duties:
<ul>
<li>Manage and oversee payer and patient revenue cycle management processes for various hospital specialty pharmacy accounts;</li>
<li>Develop operational/financial workflows to ensure billing compliance, identify efficiencies, maximize collectability, and reduce/prevent financial loss;</li>
<li>Investigate outstanding claims receivables (under/overpayments) unpaid claims or recouped payments specific by payer/PBM/site for collectability;</li>
<li>Manage Medicare B billing for each hospital specialty pharmacy partner by coordinating communications as it pertains to denials, patient eligibility and status, CMS compliance documentation needs, etc.</li>
<li>Develop strong partnerships with 3rd party Insurance payers and PBM's, our clients and internal departments that support RCM functions</li>
<li>Manage, prepare and review monthly reporting metrics for internal and external stakeholders.</li>
<li>Respond to inquiries from various PBMs, State Medicaid(s), and our health system partners as well as internal departments</li>
<li>Assist in implementation and on-boarding of revenue cycle management processes and resources for various hospital specialty pharmacy partnerships.</li>
<li>Learn to navigate hospital electronic medical record systems (i.e., Allscripts, Cerner) and pharmacy systems (i.e., RX30, QS1, ScriptPro, Epic, etc.).</li>
<li>Have a deep understanding of the unique requirements related to specialty pharmacy billing;</li>
<li>Perform additional duties or project work as assigned by revenue cycle leadership</li></ul> 


Qualifications/ Education:
<ul>
<li>Bachelor's Degree or equivalent work experience required</li>
<li>Strong knowledge of revenue cycle process and working with third party insurance and government payers</li>
<li>Ability to work independently with minimal supervision</li>
<li>Strong oral and written communication skills</li>
<li>Demonstrated prior success working in a high-volume environment and with streamlining process using data</li>
<li>Strong problem-solving capabilities. Ability to perform root cause analysis when determining areas of opportunity to improve results</li>
<li>Collaborates well with other members of formal and informal groups in the pursuit of common goals.</li>
<li>Applicants with knowledge of pharmacy dispensing systems and AR Reconciliation systems preferred</li>
<li>Microsoft Office Suite experience, especially proficiency in Excel</li></ul><div> 
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Shields Health Solutions 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.</div></div>

RCM Analyst

Floyd County Medical Center

<div>Department: Business Office
Hours: Fulltime, Day Shift, Monday-Friday
Description:
Position Overview: The Revenue Integrity Analyst is responsible for ensuring the hospital&rsquo;s revenue capture, charge structure, and reimbursement processes are accurate, compliant, and optimized. This position serves as the operational link between clinical departments, coding, billing, and finance, analyzing data, identifying revenue leakage, and driving improvement in charge capture, pricing, and denials performance. 


Essential Duties and Responsibilities:

 Charge Capture &amp; Chargemaster Oversight
<ul>
<li>Maintain, audit, and update the hospital and clinic charge description master (CDM) to ensure all charges are compliant with payer and CMS requirements.</li>
<li>Coordinate with department leaders and IT to ensure accurate charge capture, CPT/HCPCS code mapping, revenue code alignment, and pricing consistency.</li>
<li>Evaluate new services and equipment for appropriate charge setup, pricing, and reimbursement potential.</li>
<li>Conduct periodic charge reviews to identify under- or over-charging, missing charges, and documentation gaps.</li>
<li>Collaborate with clinical, coding, and billing teams to educate staff on charge capture workflows.</li></ul> 


Revenue Integrity &amp; Analytics
<ul>
<li>Monitor and analyze key revenue cycle metrics, including late charges, gross and net revenue trends, charge lag, and DNFB.</li>
<li>Develop dashboards or reports to track revenue integrity performance indicators by department or service line.</li>
<li>Lead root-cause analyses on revenue leakage and recommend corrective action plans.</li>
<li>Partner with Finance to support month-end close processes, ensuring charge and adjustment accuracy for reporting and cost accounting.</li>
<li>Support annual pricing reviews and assist in payer contract modeling for reimbursement validation.</li>
</ul>
 Denials &amp; Reimbursement Management
<ul>
<li>Track, trend, and analyze claim denials to identify systemic issues and coordinate with coding, billing, and registration teams to prevent recurrence.</li>
<li>Maintain a denials database and provide feedback to departments to improve first-pass claim accuracy.</li>
<li>Collaborate with Managed Care and Finance to review payer policies and reimbursement patterns.</li>
<li>Lead multidisciplinary denials review meetings and present findings to leadership with actionable recommendations.</li>
</ul>
Compliance &amp; Education
<ul>
<li>Ensure all charge capture, billing, and reimbursement practices comply with federal and state regulations, including CMS and OIG guidelines.</li>
<li>Serve as an internal consultant to departments regarding charge capture, coding, and documentation integrity.</li>
<li>Develop and deliver training sessions for department leaders and revenue cycle staff.</li>
<li>Support external audits and assist with internal audit initiatives related to billing and reimbursement.</li></ul> 


Minimum Education and/or Experience Required:
<ul>
<li>Associate&rsquo;s degree required; equivalent experience in revenue cycle operations may be considered in lieu of formal education.</li>
<li>Minimum of 3&ndash;5 years of experience in hospital revenue integrity, charge master maintenance, denials management, or other revenue cycle operations (critical access experience preferred).</li>
<li>Strong working knowledge of Medicare/Medicaid reimbursement, billing regulations, and compliance standards.</li>
<li>Proficiency in Meditech EMR and Microsoft Excel; familiarity with analytics tools (e.g., Power BI) preferred.</li>
<li>Ability to translate complex financial and clinical data into actionable insights.</li>
<li>Excellent communication and collaboration skills across departments.</li></ul> 


Additional Qualifications:
<ul><li>Strong attention to detail and commitment to accuracy.</li>
<li>Demonstrated integrity and ability to work independently with minimal supervision.</li>
<li>Self-motivated with the initiative to identify and complete tasks proactively.</li>
<li>Strong problem-solving and critical-thinking abilities.</li>
<li>Excellent organizational skills with the ability to prioritize assignments and manage time effectively.</li>
<li>Must be able to read, write, comprehend, and verbally communicate in English fluently.</li>
<li>Adaptive and flexible; embraces change with a positive and solution-oriented attitude.</li>
<li>Ability to operate technologies and equipment associated with this position.</li>
<li>Must have a service mindset and a commitment to continuous learning.</li>
<li>Ability to work outside of regularly scheduled hours if needed.</li>
<li>Mandatory Reporter.</li></ul> 


Licensure/Certification Required:
<ul>
<li>CRCR (Certified Revenue Cycle Representative) certification is required, or obtained within 3 months of starting.</li></ul> 


Physical/Cognitive Requirements:
<ul>
<li>Sit: Constant</li>
<li>Stand: Frequent</li>
<li>Walk: Frequent</li>
<li>Lift:
<ul><li>10 pounds Frequent</li>
<li>25 pounds: Occasionally</li>
<li>50 pounds*: Occasionally</li>
<li>75 pounds*: Never</li>
<li>Greater than 100 pounds*: Never</li>
</ul></li><li>Carry:
<ul><li>10 pounds: Frequent</li>
<li>25 pounds: Occasionally</li>
<li>50 pounds*: Occasionally</li>
<li>75 pounds*: Never</li>
<li>Greater than 100 pounds*: Never</li>
</ul></li><li>Push/Pull:
<ul><li>10 pounds: Occasionally</li>
<li>25 pounds: Occasionally</li>
<li>50 pounds*: Occasionally</li>
<li>75 pounds*: Occasionally</li>
<li>Greater than 100 pounds*: Occasionally</li>
</ul></li><li>Squat/Kneel/Crouch: Frequent</li>
<li>Climb: Occasionally</li>
<li>Balance: Occasionally</li>
<li>Twist: Frequent</li>
<li>Bend/Stoop: Frequent</li>
<li>Crawl: Frequent</li>
<li>Grasp/Grip: Constant</li>
<li>Talk: Constant</li>
<li>Hear: Constant</li>
<li>See: Constant</li>
</ul>
<ul><li>Anything greater than 50 pounds- assist of two or more, or mechanical lift are required.</li></ul> 


Environmental Factors:
<ul><li>May be exposed to communicable diseases due to working in a health care environment.</li>
<li>Works in a well-illuminated climate-controlled environment.</li>
<li>Work environment is comfortable, with minimal exposure to physical hazards.</li>
<li>Moderate noise level when machines/equipment in use but typically quiet environment.</li></ul> 


Organizational Relationships:
Reports to: Chief Financial Officer (or Revenue Cycle Director)

Employees supervised: None</div>

Revenue Integrity Analyst

IGarner System

Job Advert: Senior AR Specialist &ndash; Workers' Comp, PIP, &amp; No-Fault ClaimsAre You a Claims-Juggling Expert? Master the Revenue of the Most Complex Medical Billing Systems![Your Company Name] is a rapidly growing leader in [Your Industry/Specialty, e.g., Orthopedics, Physical Therapy, Revenue Cycle Management]. We are seeking a highly skilled and analytical AR Specialist to join our team, focusing exclusively on the challenging and lucrative Accounts Receivable (AR) for Workers' Compensation (WC), Personal Injury Protection (PIP), and No-Fault claims.If you thrive on uncovering denied revenue, navigating state-specific fee schedules, and closing out high-dollar, multi-party claims, this role is for you.What You'll Do: The Core MissionYou will be the final authority and lead executor for our most complex and high-value AR accounts. Your primary mission is to ensure maximum, timely reimbursement for services rendered under WC, PIP, and No-Fault guidelines.<ul><li>Aggressive Claims Follow-Up: Manage a specialized aging report, prioritizing accounts based on value and timely filing limits for WC, PIP, and No-Fault claims.</li><li>Denial Management &amp; Appeals: Investigate and resolve all claim denials, including those related to compensability, medical necessity, pre-authorization, and state fee schedule discrepancies. Draft and submit formal first- and second-level appeals.</li><li>Fee Schedule Mastery: Expertly read, interpret, and apply state-specific Workers' Compensation Fee Schedules and No-Fault state regulations to ensure accurate payment.</li><li>Payer Communication: Maintain professional, results-driven communication with WC Adjusters, PIP Carriers, and legal firms to push claims to final payment or settlement.</li><li>Coordination of Benefits (COB): Navigate complex scenarios where WC and PIP are secondary to each other or another insurance, ensuring proper balance-billing rules are followed.</li></ul>What You'll Bring: Essential Qualifications<ul><li>3+ years of dedicated, hands-on experience managing Accounts Receivable for Workers' Compensation and/or Personal Injury Protection (PIP)/No-Fault medical claims.</li><li>In-depth knowledge of at least one major No-Fault state (e.g., NY, FL, MI, NJ) regulations and their corresponding medical fee schedules.</li><li>Proven ability to successfully overturn denied claims and reduce days in AR for complex payer groups.</li><li>Strong understanding of medical terminology, CPT/ICD-10 codes, and their impact on claims adjudication.</li><li>Exceptional organizational skills and the ability to manage a high-volume pipeline of complex cases with detailed documentation.</li></ul>Job Type: Full-timePay: Rs60,000.00 - Rs80,000.00 per monthWork Location: In person

Medical Billing Specialist

MaxRemind

MaxRemind is seeking a Medical Billing Specialist to join our professional team in Rawalpindi (Onsite). The ideal candidate will possess strong analytical skills, attention to detail, and a solid understanding of medical billing processes within the US healthcare system.Key Responsibilities:<ul><li>Prepare, submit, and follow up on insurance claims to ensure timely payments.</li><li>Verify patient insurance coverage, eligibility, and benefits.</li><li>Accurately apply CPT, ICD-10, and HCPCS codes as required.</li><li>Resolve denied claims through effective communication with patients, providers, and insurance companies.</li><li>Maintain accuracy, confidentiality, and compliance with HIPAA and company policies.</li></ul>Qualifications and Requirements:<ul><li>Bachelor&rsquo;s degree (Mandatory).</li><li>6 months &ndash; 1.5 years of experience in medical billing or the revenue cycle process.</li><li>Proficiency in billing software, coding standards, and insurance processes.</li><li>Excellent communication, analytical, and problem-solving skills.</li><li>Strong attention to detail and ability to work independently and efficiently.</li></ul>Benefits:<ul><li>Competitive salary package.</li><li>Lunch and tea provided.</li><li>Career growth and learning opportunities.</li><li>Supportive and collaborative team environment.</li></ul>Timings: 08:00 AM &ndash; 05:00 PM Location: Near Old Airport. Fazal Town Phase 2, Rawalpindi, Pakistan (Onsite) Apply at: hr@mrremind.comJob Type: Full-timePay: Rs40,000.00 - Rs50,000.00 per monthWork Location: In person

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