Revenue Cycle Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $21 - $25 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Sprinter Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2021

☁️ SaaS

🤝 B2B

🧘 Wellness

💰 $33M Series A on 2021-11

SaaS • B2B • Wellness

Sprinter Health is a hybrid in-home and virtual primary care provider that expands access to proactive, preventive healthcare by combining community-based, W-2 “Sprinters” (trained phlebotomists with medical assistant and community health worker skills) who perform hands-on diagnostics and wellness checks in patients’ homes with a virtual clinical team of physicians, nurses, pharmacists, and care navigators. Their full-stack platform and operations close care gaps, deliver preventive screenings and diagnostics, coordinate medications and referrals, and scale longitudinal primary care and wellness visits for payer and provider partners and patients.

📋 Description

• Reconcile ERA/EOB payments against expected reimbursement; identify and resolve underpayments, overpayments, and missing remittances • Investigate and resolve payment posting flags in the billing system • Maintain AR aging across assigned payer relationships — work buckets by age and priority • Communicate directly with payer representatives to resolve outstanding balance disputes • Coordinate with our RCM platform team on shared AR workqueues — track what the platform owns vs. what is handled internally • Perform pre-submission claim scrubbing — catch errors in demographics, eligibility, authorization, coding completeness, and payer-specific requirements before submission • Verify patient eligibility and benefits across assigned payers prior to claim submission • Validate prior authorization requirements and confirm auth numbers are captured correctly on claims • Flag recurring pre-submission error patterns to the RCM Manager with recommendations for upstream workflow fixes • Resolve claim rejections from our RCM platform and payer portals, including 277 rejection reports and real-time rejection queues • Distinguish between clearinghouse-level fixes and payer-level fixes; coordinate with the platform team accordingly • Maintain a rejection tracking log, tagging by error type, payer, and root cause • Work collaboratively with the Denial Specialists to ensure upstream rejections don't re-enter as downstream denials

🎯 Requirements

• 3+ years of medical billing experience spanning at least two of the three core functions: AR reconciliation, claim submission/QA, or rejection management • Comfort managing multiple work queues simultaneously and reprioritizing based on aging and volume • Experience working ERA/EOB reconciliation at volume — payer-level batch reconciliation, not just individual claims • Familiarity with 837 claim files, 277 rejection reports, and ERA/835 remittance files • Experience with Medicaid managed care and Medicare Advantage payer requirements • Clearinghouse and RCM platform fluency — experience with leading billing platforms a plus, not required

🏖️ Benefits

• Health insurance • Flexible work arrangements