Senior RCM Specialist

Job Summary:

The Senior Revenue Cycle Management (RCM) Specialist is responsible for managing, optimizing, and
overseeing the full revenue cycle process across insurance verification, charge capture, coding review,
claims submission, denials management, and collections. This individual serves as the subject-matter
expert and escalation point for complex payer, coding, or reimbursement issues. The Senior RCM Specialist
helps drive financial performance and ensures compliance with industry standards and payer regulations.

Key Responsibilities
1. Claims Processing & Billing Oversight
2. Insurance Verification & Prior Authorizations
3. Denials, Appeals, & A/R Management
4. Payment Posting & Reconciliation
5. Compliance & Quality Assurance
6. Reporting & Process Improvement
7. Cross-Functional Collaboration

Required Qualifications
Bachelors degree in Healthcare Administration, Business, Finance, or 
Minimum of 5 years of hands-on experience in U.S. medical billing and revenue cycle management.
Strong expertise in insurance guidelines, reimbursement methodologies, and denial management
strategies.
Experience with common EMR/EHR and billing platforms (e.g., Athena, Kareo, eCW, DrChrono,
Epic).

Skills
Knowledge of CPT, ICD-10, and HCPCS coding principles.
Strong analytical, organizational, and problem-solving ability.
Excellent written and verbal communication for working with payers and providers.
Ability to work independently, prioritize workload, and lead process improvement initiatives.
High accuracy and attention to detail.