Remote Revenue Integrity Specialist for Healthcare Company

Work From Anywhere in LATAM or the Philippines

Work Schedule: ET | Flexible hours aligned to US payer business hours

A US-based healthcare provider in the Applied Behavior Analysis space is scaling its Revenue Cycle Management function and hiring a Revenue Integrity Specialist to own the post-submission side of the revenue cycle and recover revenue that has gone unworked.

The company is restructuring a previously generalist RCM team into dedicated specialist lanes — billing, denials, and revenue integrity — so each function has a single owner. The team is small, the manager is hands-on, and the expectation is full visibility: daily queue updates in a shared Slack channel and direct escalation when something blocks a claim from closing.

This role centers on stale claim management, aging AR follow-up, and payment accuracy verification. Day-to-day work lives inside a billing platform, an outbound phone queue (10-25 insurance carrier calls per day), and a shared billing inbox for paper remits. Success means consistent claims removed from the queue every day, days in AR trending downward, and every underpayment identified and pursued — not written off.

Must-Have

• 1+ year of medical billing or revenue cycle experience working directly with US insurance payers
• Demonstrated experience with high-volume outbound phone work — minimum 10+ calls per day to external parties (insurance carriers, payer service lines, or equivalent)
• Hands-on use of a payer portal such as Availity for claim status checks, follow-up, and documentation
• Proficiency reading and interpreting EOBs and ERAs to identify underpayments, short pays, and incorrect adjustments
• Experience documenting payer interactions with rep names, reference/ICN numbers, outcomes, and next steps in a billing platform or CRM
• Ability to work US Eastern Time hours to align with insurance carrier call windows
• C1+ English (CEFR) for daily written updates, outbound payer calls, and direct communication with a US-based RCM manager

Nice-to-Have

• Prior call center, receptionist, or heavy-phone-volume background with experience handling difficult or adversarial calls
• Experience working within Candid or a comparable RCM/billing platform
• ABA or behavioral health billing background
• Familiarity with CARC/RARC codes and secondary billing or Coordination of Benefits (COB) processes
• Experience with payers such as TRICARE, HMSA, Medicaid, or major commercial insurers
  
  

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