RCM Associate, Member AR, Pre-Access – Contractor

Job not on LinkedIn

🔥 4 minutes ago

🇺🇸 United States – Remote

⏳ Contract/Temporary

🟡 Mid-level

👻 Ghost score 15%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Sword Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2015

🏥 Healthcare

☁️ SaaS

🤖 Artificial Intelligence

Healthcare • SaaS • Artificial Intelligence

Sword Health is a digital health company offering an AI Care platform that combines artificial intelligence with licensed clinicians to provide virtual care primarily for musculoskeletal (MSK) pain, women's health, cardiometabolic health, and mental health. Their platform includes AI-driven digital physical therapy for pain (Thrive), women's health program (Bloom), cardiometabolic program (Pulse), mental health support (Mind), and Predict, an AI engine to identify members at high risk for avoidable surgeries. Sword sells to employers, health plans, unions, consultants & brokers, and individuals, focusing on measurable cost savings, surgical avoidance, and improved clinical outcomes. They emphasize security, privacy, and clinical evidence with peer-reviewed studies and validated ROI.

📋 Description

• Support timely and accurate financial clearance and claims submission • Research and resolve authorization, referral, eligibility, and member billing questions • Review authorization, referral, and eligibility issues and resolve them while meeting productivity and quality targets • Learn and apply payer-specific requirements, including authorizations, referrals, carve-outs, and TPA plans • Communicate with members to obtain financial information and verify insurance coverage • Calculate member financial responsibility and provide accurate cost estimates • Review billing activity and transaction history to answer member billing questions • Record and reconcile member payments in the practice system • Identify collection opportunities, including payment plans and hardship applications, and escalate as appropriate • Coordinate with coding, clinical, and Member Support teams on billing questions • Maintain accurate member records in electronic medical record and billing systems • Pull reports and review balance and authorization data to identify trends and share findings • Flag workflow pain points and suggest improvements • Support workflow rollouts and maintain standard operating procedure documentation • Partner with teammates and occasionally Product / Engineering to resolve RCM issues • Escalate complex or unresolved issues to the team lead or manager • Uphold HIPAA compliance guidelines and relevant regulations

🎯 Requirements

• 3+ years of Revenue Cycle Management experience, with working knowledge of medical billing claims • Familiarity with financial clearance, insurance verification, or authorizations • Experience speaking directly with members or patients about billing or insurance • Working knowledge of billing, coding, and claims follow-up • Experience communicating with payers to resolve issues • Proficiency in Excel and comfort with basic data analysis • Comfort with claims billing software and Microsoft Office, and a desire to learn new tools • Ability to work across multiple systems and workflows • Strong attention to detail and problem-solving skills • Strong communication and interpersonal skills • Self-starter who asks questions and learns quickly • Passion for advocating for Headspace’s members • Every hire must demonstrate at least Level 1 AI proficiency • Preferred: Experience in behavioral health, mental health, telehealth, or digital health billing • Preferred: Experience in B2B2C healthcare • Preferred: Exposure to health plan / EAP

🏖️ Benefits

• Sword offers additional benefits beyond total compensation; country-specific benefits may vary and will be detailed separately

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