Revenue Cycle Specialist (Remote - US)

This position is posted by Jobgether on behalf of Medical Guardian. We are currently looking for a Revenue Cycle Specialist in United States.

As a Revenue Cycle Specialist, you will take ownership of a dedicated portfolio of Medicaid payer accounts, ensuring accurate and timely reimbursement for essential healthcare services. You’ll be responsible for investigating claim discrepancies, addressing denials, and working collaboratively to maximize revenue. This remote role requires a detail-oriented and proactive professional with strong problem-solving skills and knowledge of payer-specific guidelines. If you're analytical, organized, and thrive in a deadline-driven environment, this is an opportunity to make a meaningful impact in a mission-oriented team.

Accountabilities:

• Manage a designated portfolio of Medicaid payers and serve as the primary point of contact for resolution.
• Conduct proactive follow-up on outstanding claims to secure timely reimbursement.
• Review, analyze, and appeal denied or underpaid claims in accordance with payer-specific rules and contract obligations.
• Identify and escalate patterns in denials or underpayments to management.
• Communicate with insurance companies via portals, phone, or written correspondence.
• Ensure all claim activity is documented accurately for auditing and tracking purposes.
• Submit corrected claims or reconsideration requests when necessary.
• Maintain compliance with payer timelines, authorization processes, and guidelines.

Participate in a remote team environment with minimal patient interaction and limited phone work (mainly with care managers).

• High school diploma or equivalent (associate or bachelor’s degree preferred).
• At least 2 years of experience in medical billing or revenue cycle management, focusing on A/R and insurance follow-up.
• Knowledge of Medicaid and Managed Care Organizations is a strong advantage.
• Proficient in Microsoft Office applications.
• Strong analytical and critical thinking skills to resolve complex issues.
• Excellent oral and written communication abilities; professional and friendly phone demeanor.
• Organized, detail-oriented, and able to manage multiple priorities independently in a remote setup.
• Experience with Salesforce and/or Waystar is a plus.
• Must reside in PA, DE, GA, MI, NC, TX, NJ, or FL.

• Competitive hourly rate of $22/hour.
• Remote, full-time position (Monday–Friday, 9:00 AM–5:00 PM EST).
• Comprehensive Health Care Plan (Medical, Dental, Vision).
• Paid Time Off, including vacation and public holidays.
• Short-Term and Long-Term Disability coverage.
• 401(k) Retirement Plan.
• Supportive team culture focused on work-life balance.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.
When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.
🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.
📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.
🎯 Based on this analysis, we automatically shortlist the 3 candidates with the highest match to the role.
🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.
The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role.
Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team.
Thank you for your interest!

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