Senior Specialist, Revenue Cycle Management

About this role

We are looking for a highly skilled and strategic Senior RCM Specialist to join our team. This role will play a critical part in driving operational excellence within our revenue cycle with a particular focus on our rapidly evolving Enterprise accounts.

The ideal candidate brings deep experience in revenue cycle operations and coding, along with strong knowledge of insurance payer systems and reimbursement processes. They are confident in leading cross-functional collaboration and can represent the RCM team with clarity and authority. You’ll help us solve complex billing issues, optimize claims performance, and protect the integrity of our operations as we scale.

What you’ll Do

• Take ownership of RCM operations for our Enterprise accounts, leading claim resolution and workflow optimization efforts.
• Serve as a key RCM point of contact in cross-functional meetings, representing the team in discussions with Product, Clinical, Customer Success, Implementation, and external partners.
• Oversee escalated claim and coding issues, including working directly with payers, vendors, and providers to resolve denials and rejections.
• Collaborate with internal clinical and operations teams to improve documentation quality, support proper coding, and reduce avoidable denials.
• Supervise and guide vendor relationships, including coding and denial management partners, with a focus on quality and compliance.
• Lead Enterprise-focused initiatives related to new care models, coding strategies and opportunities to optimize billing processes for complex accounts.
• Stay current on payer-specific coding regulations and trends that impact Enterprise clients, and bring forward proactive solutions to address evolving policies and compliance risks.
• Provide targeted support for Enterprise workflows, including documentation and process development, while serving as a resource to the broader team as needed.
• Assist as needed on RCM for our direct-to-consumer telehealth business, including compliance and reimbursement for commercial and Medicare lines of business

What you bring

• 5+ years of progressive experience in Revenue Cycle Management, including claim resolution, coding, and payer engagement.
• Proven experience navigating Enterprise accounts and complex payer policies, particularly in telehealth or digital healthcare environments.
• Expertise in coding compliance, denial management, and provider education.
• Strong understanding of health plan reimbursement guidelines
• Experience working cross-functionally with clinical teams and external vendors.
• Ability to think strategically and operationally—balancing day-to-day tasks with long-term improvement initiatives.
• Excellent communication and documentation skills.
• Experience managing sensitive workflows requiring discretion, system access, and domain expertise.
• Experience supporting and interfacing with enterprise customers and internal collaborators such as customer success teams

Certifications (Preferred)

• Certified Professional Coder (CPC) from AAPC or equivalent accredited certification.