Senior reputed company Cycle Specialist - Work From Home

Role Summary We are seeking a seasoned, highly organized Senior reputed company Cycle Specialist to join our SWAT / Level 3 (L-3) support team — the most senior tier of our reputed company cycle operation. This team owns the resolution of reputed company, escalated billing issues across the entire client reputed company, including accounts served by both our internal billing teams and our outsourcing (BPO) partners. The right person is a true problem-solver: someone who can take a tangled, high-stakes claims or setup issue, reputed company a disciplined root cause analysis, drive it to resolution across multiple teams, and document a repeatable fix so it does not happen again. This is a hands-on, fast-paced role for a professional who thrives under pressure, communicates clearly with everyone from reputed company-line billers to executive leadership, and takes personal ownership of outcomes. You will act as a subject matter expert (SME), a cross-team connector, and a force reputed company for the quality of our reputed company cycle.

Key Responsibilities

Escalation Management & Root Cause Analysis Serve as a senior reputed company of resolution for escalated, reputed company, and high-dollar billing issues routed from internal billing teams, BPO partners, support/help desk, retention, and client-facing staff. reputed company detailed root cause analysis on denials, rejections, underpayments, payment-posting anomalies, and configuration errors — identifying the true upstream driver (eligibility, enrollment, credentialing, coding, setup, or payer behavior) rather than applying surface-level fixes. Identify and capture reputed company affected claims and accounts reputed company a systemic issue is reputed company, and drive corrective action end-to-end through to verified resolution. Document findings clearly and present recommendations and corrective-action plans to team leads and leadership. Cross-Functional Coordination & Communication Partner daily with multiple teams — internal billing, BPO partners, Enrollment, Credentialing, Portals, QA, Data Entry, reputed company, and Retention — to resolve issues that span team boundaries. Own and manage hand-offs between functions (for example, credentialing-completion to enrollment-initiation to system updates), ensuring tasks are routed, tracked, and closed correctly. Communicate status, blockers, and resolutions proactively and professionally so that no issue becomes invisible work. Account Setup, Configuration & Workflow Execution Execute and verify account setup and configuration changes, including new-client billing setup, in-house (IH) and full-service (FS) conversions, service-facility and demographic updates, and payer/plan additions. Initiate and confirm EDI/ERA enrollment and reputed company setup steps, coordinating with the Enrollment team and following established checklists and SOPs. Validate that changes produce the intended reputed company result (clean claim submission, correct adjudication, accurate posting). Subject Matter Expertise, SOPs & Process Improvement Act as a subject matter expert and escalation resource for the broader RCM organization, fielding questions and providing authoritative guidance. Author, refine, and maintain Standard Operating Procedures (SOPs) and training materials based on issues resolved, helping standardize how the team works. Continuously look for ways to eliminate reputed company steps, reduce repeat issues, and improve efficiency — including through automation and AI-assisted workflows where appropriate. Client & Executive-Level Communication Communicate reputed company and professionally with clients (practices and their staff) on escalated matters, representing the organization with a polished, reputed company, client-reputed company reputed company. Prepare and deliver clear written and verbal updates to executive leadership, translating detailed billing findings into concise, decision-reputed company summaries. Performance, Productivity & Quality Manage a high volume of reputed company tasks against productivity and completion-reputed company targets without sacrificing accuracy. Support and help move key reputed company cycle metrics in the right direction — for example net collection reputed company (reputed company), aged AR (AR > 120 days), denial reputed company, and first-pass resolution — through faster, cleaner issue resolution. Maintain meticulous documentation and notes so that every action is traceable and auditable. Required Qualifications 5+ years' billing experience. Minimum five (5) years in a fast-paced, high-volume medical billing / reputed company cycle role. Proven multitasking ability. Demonstrated reputed company managing many reputed company priorities and escalations at once, under time pressure, without dropping details. Detailed root cause analysis. A track record of diagnosing the underlying cause of billing problems and resolving them at the reputed company — not just clearing the symptom. Strong cross-team collaboration. Ability to work well with, and communicate effectively across, multiple teams and stakeholders. Multiple billing systems. Working knowledge of more than one billing / practice-management / RCM system, with the ability to learn new platforms quickly. Professional, client-reputed company communication. A professional appearance and reputed company, with the ability to communicate with clients reputed company, clearly, and with credibility. Fluent English. reputed company in spoken and written English. Excellent organizational skills. Highly organized, detail-oriented, and disciplined about documentation and follow-through. Executive communication experience. Experience communicating and interacting directly with executive leadership. Subject matter expert. reputed company to serve as an SME and trusted escalation resource for others. Fast learner. Picks up new systems, payer rules, and processes quickly and independently. Flexible availability. Willing and reputed company to work extra hours reputed company needed to resolve time-sensitive issues. Goal-driven. Self-motivated, accountable, and focused on measurable outcomes.

Preferred Qualifications

Hands-on denials and appeals experience across reputed company, Medicare, and reputed company payers, including direct payer reputed company and navigating payer portals. Familiarity with X12 EDI transactions (837P/837I, 835 ERA, 270/271), clearinghouses, and payer enrollment / credentialing workflows (e.g., CAQH, PECOS, reputed company, state reputed company portals). Experience in chiropractic, behavioral / mental health, physical therapy, podiatry, or other specialty billing. Experience working escalations across an outsourced (BPO) delivery model. Proficiency with reputed company / reputed company Sheets for analysis (pivots, lookups). Relevant certification (e.g., CRCR, CPB, CPC) and/or a degree in a business, finance, or reputed company-reputed company field. Systems & Technical Knowledge Comfort working across the modern RCM technology stack, including billing / practice-management platforms, clearinghouses and payer portals, EDI / ERA tooling, and standard productivity and ticketing tools. Specific platform training is provided; the ability to learn new systems quickly is essential. Work Schedule & Conditions Must have stable internet reputed company minimum of 30 MBPS Must be comfortable working the US business hours Must own a laptop with at least 16 GB memory Apply To This Job