RCM Associate, Member AR & Pre-Access (Contractor)

SWORD Health; United States; Remote; USD 30,000 - 34,000; Full time

Job summary

Sword Health is hiring a Billing Specialist to blend healthcare experience with a fast-paced environment. You will support timely financial clearance and claims submission while resolving authorizations, referrals, and eligibility questions. Document and improve billing processes from start to finish.

You’ll collaborate with billing, coding, and support teams to ensure accurate records, communicate costs to members, and help optimize workflows in a HIPAA-compliant setting.

Qualifications

• 3+ years of Revenue Cycle Management experience with working knowledge of medical billing claims.
• Familiarity with financial clearance, insurance verification, or authorizations.
• Experience speaking directly with members about billing or insurance.
• Working knowledge of billing, coding, and claims follow-up.
• Experience communicating with payers to resolve issues.
• Proficiency in Excel and comfort with basic data analysis.
• Comfort with billing software and Microsoft Office, and a desire to learn new tools.
• Ability to work across multiple systems and workflows.
• Strong attention to detail and problem-solving skills.
• Strong communication and interpersonal skills.
• Self-starter who asks questions and learns quickly.

Responsibilities

• Review authorization, referral, and eligibility issues and drive them to resolution while meeting productivity and quality targets.
• Learn payer-specific requirements, including authorizations, referrals, carve-outs, and TPA plans.
• Communicate with members to obtain financial information and verify insurance coverage.
• Calculate member financial responsibility and provide accurate cost estimates.
• Record and reconcile member payments in the billing system.
• Identify collection opportunities and elevate as appropriate.
• Coordinate with the coding team and clinicians on coding questions and with Member Support on billing queries.
• Maintain accurate member records in the EMR and billing systems.
• Pull reports to spot trends and share findings with leadership.

Skills

Revenue Cycle Management

Communication skills

Excel proficiency

Data analysis

Attention to detail

Problem solving

Self-starting

Cross-system experience

Tools

Billing software

Microsoft Office

EMR systems

Job description

Location: United States

At Sword, we’re building AI to heal billions and unlock humanity’s full potential. In doing so, we’re pioneering AI Care, a fundamentally new approach to healthcare built for medical reasoning, safety, and real-time treatment, not generic technology applied after the fact. As both a clinical-centric frontier AI lab and an applied AI platform, Sword is reimagining how care is delivered at scale, removing traditional barriers like appointments, waiting rooms, and stigma so more people can access the care they need—and ultimately get back to lives lived in full.

Since 2020, Sword has expanded across physical therapy, women’s health, cardiometabolic, and mental health, and is now moving beyond the session to a fully AI-native, 24/7 care program that brings physical activity, therapeutic exercise, psychotherapy, nutrition, and behavior change into one connected experience. More than 700,000 members across three continents have completed over 10 million AI sessions, helping 1,000+ enterprise clients avoid more than $1 billion in unnecessary healthcare costs. Backed by 42 clinical studies, 44+ patents, and more than $500 million raised from leading investors including Khosla Ventures, General Catalyst, and Founders Fund, Sword is defining a new standard for healthcare.

AI Proficiency at Sword

AI fluency is a core expectation at Sword. Every candidate is assessed against our three-level framework — be ready to share real examples of how AI is already part of how you work.

• Explorer (Level 1) — Uses AI daily to boost personal productivity
• Builder (Level 2) — Creates workflows and tools that elevate the whole team
• Integrator (Level 3) — Embeds AI into products and processes at scale

Every hire must demonstrate at least Level 1. The expected level will vary depending on the seniority of the role.

Role

We’re looking for a Billing Specialist who can combine their healthcare experience with a fast-paced and ever-changing environment. You’ll work with the Billing team to support timely and accurate financial clearance and claims submission, research and resolve authorization, referral, eligibility, and member billing questions, and help document and improve team processes so billing is handled correctly from start to finish.

What you’ll be doing

• Review authorization, referral, and eligibility issues from the billing team, and work them to resolution while meeting productivity and quality targets
• Learn and apply payer-specific requirements, including authorizations, referrals, carve-outs, and TPA plans
• Communicate with members to obtain financial information and verify insurance coverage
• Calculate member financial responsibility and provide accurate cost estimates
• Review billing activity and transaction history to answer member billing questions
• Accurately record and reconcile member payments in the practice system
• Identify collection opportunities, including payment plans and hardship applications, and elevate as appropriate
• Coordinate with the coding team and clinicians when coding questions arise, and with Member Support on billing and collection questions
• Maintain accurate and complete member records in the electronic medical record and billing systems
• Pull reports and review balance and authorization data to spot trends, and share findings with your lead or manager
• Flag workflow pain points and suggest improvement ideas
• Support new workflow rollouts and help keep standard operating procedure documentation up to date
• Partner with teammates, and occasionally Product / Engineering, to resolve RCM issues
• Escalate complex or unresolved issues to the team lead or manager
• Complete other assignments as requested
• Uphold HIPAA compliance guidelines and all relevant regulations

What you need to have

• 3+ years of Revenue Cycle Management experience, with working knowledge of medical billing claims
• Familiarity with financial clearance, insurance verification, or authorizations
• Experience speaking directly with members or patients about billing or insurance
• Working knowledge of billing, coding, and claims follow-up
• Experience communicating with payers to resolve issues
• Proficiency in Excel and comfort with basic data analysis
• Comfort with claims billing software and Microsoft Office, and a desire to learn new tools
• Ability to work across multiple systems and workflows
• Strong attention to detail and problem-solving skills
• Strong communication and interpersonal skills
• Self-starter who asks questions and learns quickly
• Passion for advocating for Headspace’s members

Preferred:

• Experience in behavioral health, mental health, telehealth, or digital health billing
• Experience in B2B2C healthcare
• Exposure to health plan / EAP

*The range below reflects base, variable, and equity for this role.

This is a starting point, not a ceiling — once someone joins and proves they're outlier talent, we adjust quickly to make sure their compensation matches their impact.

Job titles may span more than one career level, so actual pay depends on skills, qualifications, experience, location, and market demand, among other factors. The range reflects base salary plus any variable, bonus, or sales incentives, and our estimate of the value of private company stock options where applicable. It's subject to change, and future stock value isn't guaranteed. Sword also offers additional benefits beyond total compensation.

Total Compensation Range

€22—€25 EUR

Country-specific benefits may vary and will be detailed separately.

Sword Health complies with applicable Federal and State civil rights laws and does not discriminate on the basis of Age, Ancestry, Color, Citizenship, Gender, Gender expression, Gender identity, Gender information, Marital status, Medical condition, National origin, Physical or mental disability, Pregnancy, Race, Religion, Caste, Sexual orientation, and Veteran status.