RCM Payment Reconciliation Specialist

Finni Health; Northern (KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Finni Health is seeking an RCM Payment Reconciliation Specialist to ensure accurate tracking, posting, and matching of healthcare financial transactions across clinical systems and bank deposits.

You will resolve balance discrepancies, audit transaction flows, and safeguard cash integrity across the revenue cycle, partnering with payers and internal teams to optimize performance.

Qualifications

• 3+ years in RCM payment posting or related roles.
• Experience with billing, claims, collections and denials.
• Strong analytical and data-driven decision making.

Responsibilities

• Reconcile ERAs, EOBs, and patient payments against bank account transactions.
• Research and resolve unposted cash, partial payments, write-offs, and unapplied balances.
• Work with payers on missing payments and resissuance of payments; collaborate with stakeholders.
• Generate daily, weekly, and month-end reconciliation reports and track KPIs.
• Adapt to evolving responsibilities and projects as Finni Health grows.

Skills

RCM expertise

Analytical thinking

Problem solving

Process improvement

Collaboration

Time management

Attention to detail

Tools

Google Suite

Slack

CRM/support software

EHR/RCM tools

Job description

About Finni Health

Finni Health empowers autism care providers to start, run, and grow their own practices. We democratize autism care by providing access to our insurance network, purpose-built EHR software, HR solutions, and clinical support. We've experienced rapid growth and are backed by top-tier investors like General Catalyst and YCombinator. We seek smart, driven individuals eager to innovate in a dynamic, fast-paced environment.

What You Will Be Doing:

The RCM Payment Reconciliation Specialist ensures accurate tracking, posting, and matching of all healthcare financial transactions across clinical systems, electronic remittance advices (ERAs), paper Explanation of Benefits (EOBs), and bank deposits. You will resolve balance discrepancies, audit transaction flows, and safeguard cash integrity across the entire revenue cycle.

Key Responsibilities

• Payment Reconciliation: Reconcile ERAs, EOBs, and patient payments against against bank account transactions

• Variance and Discrepancy Resolution: Research and resolve unposted cash, partial payments, contractual allowances, underpayments, write-offs, and unapplied balance accounts

• Payer and Patient Escalations: Work with payers on missing payments and resissuance of payments; Collaborate with stakeholders to obtain check payments incorrectly issued to clinics and/or patients

• Reporting and Collaboration: Generate daily, weekly, and month-end reconciliation reports, tracking key performance metrics (e.g., aging unposted cash, posting turnaround times) for RCM and finance leadership

• Additional Responsibilities: Adapt and take on evolving responsibilities and projects as Finni Health grows and the RCM landscape changes.

About You:

You are a proactive and collaborative individual contributor with a strong background in revenue cycle management, driven by a commitment to operational excellence and financial performance.

• Experience: 3+ years of relevant experience in RCM payment posting, RCM operations, or related roles, preferably in an early-stage startup, behavioral or mental health, or healthcare tech. Strong understanding of RCM processes, including billing, claims, collections, denial appeals, and accounts receivable management.

• Collaborative & Independent Contribution: Proven ability to work effectively within a team environment, contributing to collective success, and independently driving RCM initiatives.

• RCM Expertise: Deep understanding of the full revenue cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance (e.g., CMS billing).

• Analytical & Problem-Solving: Strong ability to analyze complex RCM/Finance data, identify trends, root causes of issues, and implement effective, data-driven solutions to optimize financial performance.

• Process Optimization: Demonstrated expertise in identifying inefficiencies and driving process improvements for RCM/Finance efficiency and effectiveness.

• Communication & Collaboration: Excellent written and verbal communication skills, with proven ability to effectively collaborate with internal teams and external stakeholders (payers, vendors, providers).

• Organizational & Time Management: Exceptional organizational and time management skills, with the ability to manage multiple priorities and projects in a fast-paced environment.

• Tech Proficiency: Proficient in Google Suite, Slack, CRM/support software, and EHR/RCM management tools. Experience with various EMR/EHR work queue management within RCM is a plus.

• Mission Alignment: Passion for Finni’s mission to democratize autism care and empower providers through robust RCM.

• Adaptability & Agility: Comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive mindset.

Ready to make a significant impact at a rapidly growing healthcare startup? We'd love to hear from you!