Revenue Cycle Specialist

About the role

We are seeking a Revenue Cycle Specialist to join our dynamic team at Sprinter Health. The ideal candidate will be responsible for ensuring accurate billing processes, from pre-submission claim scrubbing to accounts receivable reconciliation.

Responsibilities

• AR & Reconciliation (~40% of role): Reconcile ERA/EOB payments against expected reimbursement; identify and resolve underpayments, overpayments, and missing remittances
• Claim Submission & Pre-submission QA (~35% of role): Perform pre-submission claim scrubbing; verify patient eligibility and benefits; validate prior authorization requirements
• Rejection Resolution (~25% of role): Resolve claim rejections from our RCM platform and payer portals; maintain a rejection tracking log

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

Nice to have

• Experience resolving capitation or encounter-based payment methodology disputes with payers
• Prior experience in a lean or startup RCM environment
• Exposure to value-based care or risk-adjusted billing models
• CMS-1500 and UB-04 experience across both institutional and professional billing