Enterprise Revenue Cycle Specialist

The Enterprise Revenue Cycle Specialist is responsible for managing Accounts Receivable and resolving clearinghouse rejections across multiple specialties and clients. This role requires deep end to end revenue cycle knowledge, with a primary focus on claim correction, payer follow up, and driving timely reimbursement.This individual operates in a high volume, multi client environment and is expected to work independently, identify root causes, and reduce rework through accurate and efficient resolution of claim issues.Core ResponsibilitiesAccounts Receivable ManagementPerform timely follow up on outstanding AR across all aging bucketsAnalyze unpaid claims, identify root causes, and take appropriate action to drive resolutionWork denials, rejections, and underpayments including corrections, resubmissions, and escalationsEnsure proper documentation of all actions taken within the practice management systemPrioritize accounts based on aging, dollar value, and payer specific trendsClearinghouse Rejection ResolutionReview and correct clearinghouse rejections daily to ensure clean claim submissionIdentify trends in rejection types and implement corrective actions to reduce recurrenceValidate claim data including demographics, coding, modifiers, and payer requirementsResubmit corrected claims within defined turnaround timesClaims & Billing AccuracyEnsure claims are billed in accordance with payer guidelines and client specific rulesValidate coding, modifiers, and required data elements prior to submissionCollaborate with front end and coding teams to resolve upstream issues impacting claim qualityRoot Cause Analysis & Process ImprovementIdentify patterns in denials and rejections and escalate systemic issuesProvide feedback to leadership on workflow gaps, payer trends, and process breakdownsSupport initiatives focused on reducing AR days, denial rates, and reworkCross Functional CollaborationPartner with internal teams including QA, Automation, and Client Success to resolve issuesCommunicate effectively with clients when required to clarify billing or payer requirementsAdapt to multiple EMRs, clearinghouses, and payer systems across clientsRequired QualificationsMinimum 5 plus years of experience in Revenue Cycle Management with strong focus on AR follow up and claims or rejectionsProven experience working clearinghouse rejections and payer denials across multiple specialtiesStrong understanding of the full revenue cycle including billing, coding fundamentals, and payer guidelinesExperience working with multiple EMRs and clearinghouses such as Availity, Change Healthcare, Waystar or similarAbility to manage high volume workloads while maintaining accuracy and productivity standardsStrong analytical and problem-solving skillsPreferred QualificationsMulti-specialty experience including radiology, ophthalmology, or surgical practicesExperience in a multi-client or outsourced RCM environmentFamiliarity with automation tools or workflow optimization initiativesKey Performance IndicatorsAR resolution rate and reduction in agingClearinghouse rejection turnaround timeDenial resolution rate and rework reductionProductivity and quality accuracy scoresContribution to overall cash acceleration and revenue recoveryWork EnvironmentFast-paced, metrics driven environment supporting multiple clientsRequires adaptability across systems, workflows, and payer requirementsStrong emphasis on accountability, accuracy, and continuous improvementSalary: $26/hrOriginally posted on Himalayas