Revenue Cycle Management Specialist – CPC Required

Continuant; United States; Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health plan options

Dental and vision coverage

401(k) with company match

Paid time off

Fitness Fund reimbursement

Life insurance

Annual performance bonus

Job summary

Continuant is seeking a Revenue Cycle Management Specialist with CPC certification to manage full‑cycle medical billing and coding. The role requires hands‑on U.S. billing experience, E/M coding, and strong knowledge of CPT/ICD coding guidelines.

Responsibilities include verification, claims submission, denial management, and ensuring compliant, timely reimbursements. The candidate will work with providers on documentation, use various EHR/practice‑management systems, and help improve workflows

Qualifications

• Active CPC credential
• Three or more years of hands‑on U.S. medical billing and revenue cycle management experience, including at least one year of direct medical coding from clinical documentation
• Thorough understanding of CMS guidelines, Medicare, Medicaid, and commercial payer coding requirements
• Experience with professional fee coding, including E/M services and diagnostic services
• Experience with EHR, practice‑management and medical billing systems
• Strong analytical, organizational and communication skills
• Ability to work independently and manage multiple priorities
• Demonstrated coding from medical records beyond provider‑selected codes
• Experience supporting behavioral health, outpatient, surgical, or a combination of these settings

Responsibilities

• Manage full‑cycle medical billing including verification, entry, submission, posting, denial management and patient collections
• Review CPT/ICD‑10‑CM/HCPCS codes for accuracy and proper claim submission
• Identify and resolve coding‑related errors, rejections and denials
• Ensure timely submission to commercial payers, Medicaid and Medicare
• Conduct eligibility checks and pre‑authorizations as needed
• Follow up on outstanding claims and accounts receivable
• Analyze aging reports to identify reimbursement issues
• Work with providers to address coding, documentation, and billing questions
• Maintain HIPAA compliance and payer coding guidelines
• Support improvements across coding and billing workflows
• Use EHR and practice‑management platforms for billing and reporting
• Review provider visit notes to assign and validate codes and modifiers
• Determine appropriate E/M levels based on documentation
• Identify documentation gaps and obtain clarifications
• Apply coding rules and payer edits; research coding issues as needed

Skills

CPC credential

US medical billing

Revenue cycle management

E/M coding

HIPAA compliance

EHR systems

Analytical skills

Attention to detail

Independent work

Education

College education in healthcare administration

Tools

SimplePractice

TherapyNotes

Tebra

Practice Fusion

Modernizing Medicine

Athenahealth

Job description

Job Overview

The Revenue Cycle Management Specialist – CPC Required supports the accurate and efficient management of the revenue cycle for behavioral health, outpatient, surgical, or a combination of these practice settings. This position combines hands‑on medical billing and revenue cycle responsibilities with coding expertise to help ensure accurate claim submission, appropriate reimbursement and compliance with coding and payer requirements.

Key Responsibilities

• Manage full‑cycle medical billing, including insurance verification, charge entry, claims submission, payment posting, denial management and patient collections.
• Review CPT, ICD‑10‑CM, HCPCS codes and modifiers for accuracy and appropriate claim submission.
• Identify and resolve coding‑related claim errors, rejections and denials.
• Ensure timely and accurate claims submission to commercial payers, Medicaid and Medicare.
• Conduct eligibility checks and pre‑authorizations as needed.
• Follow up on outstanding claims and accounts receivable.
• Analyze aging reports and identify reimbursement issues and denial trends.
• Work with providers and administrative teams to address coding, documentation and billing questions.
• Maintain compliance with HIPAA, coding guidelines, payer requirements and internal policies.
• Support process improvements across coding and billing workflows.
• Use EHR and practice‑management platforms for billing, scheduling and reporting.
• Independently review provider visit notes, procedure reports, and other clinical documentation to assign and validate ICD‑10‑CM, CPT, HCPCS Level II codes, and applicable modifiers.
• Select appropriate office/outpatient evaluation and management (E/M) levels based on documented medical decision‑making or qualifying time, as applicable.
• Identify incomplete, conflicting, or insufficient documentation and obtain provider clarification before finalizing coding.
• Apply diagnosis sequencing, diagnosis‑to‑procedure linking, bundling rules, and applicable payer coding edits.
• Research coding and reimbursement issues using current coding references and official payer guidance; prepare corrected claims and supporting appeals as appropriate.

Required Qualifications

• Active Certified Professional Coder (CPC) credential.
• Three or more years of hands‑on U.S. medical billing and revenue cycle management experience, including at least one year of direct medical coding experience assigning codes from clinical documentation. Billing and coding experience may overlap.
• Demonstrated understanding of the full healthcare revenue cycle, from insurance verification and charge entry through claims follow‑up, denial resolution, payment posting, and accounts receivable management.
• Experience with professional fee coding, including Evaluation and Management (E/M) services, office visits, procedures, and diagnostic services.
• Thorough understanding of CMS guidelines, Medicare, Medicaid, and commercial payer coding requirements.
• Experience supporting behavioral health, outpatient, surgical, or a combination of these practice settings.
• Strong knowledge of CPT, ICD‑10‑CM, HCPCS, modifiers and coding guidelines.
• Experience with commercial insurance, Medicaid and Medicare.
• Hands‑on experience with claims follow‑up, denial resolution and accounts receivable management.
• Experience with EHR, practice‑management and medical billing systems.
• Strong analytical, organizational and communication skills.
• High level of accuracy and attention to detail.
• Ability to work independently and manage multiple priorities.
• Demonstrated experience coding directly from medical records, beyond entering or submitting codes selected by providers.
• Working knowledge of medical terminology, anatomy, and the clinical services relevant to assigned specialties.
• Ability to interpret remittance advice and denial reason codes, distinguish coding errors from other billing issues, and determine the appropriate resolution.
• Successful completion of a practical billing and coding assessment using de‑identified clinical documentation and claim scenarios.

Preferred Qualifications

• Experience working across multiple EHR, EMR, practice‑management, and medical billing platforms; experience with five or more systems is preferred.
• Experience with systems such as SimplePractice, Tebra, TherapyNotes, Practice Fusion, Modernizing Medicine, Athenahealth, or comparable platforms.
• Experience identifying coding‑related denial trends and improving billing workflows.
• Experience working in a remote environment.
• College education in healthcare administration, coding or a related field, or equivalent professional experience.

Benefits:

• $0 employee premium medical plan options
• Opt‑in dental and vision coverage with company benefit funding
• 401(k) with company match up to 4.5%
• Paid Time Off (PTO), sick leave, and paid holidays
• Fitness Fund reimbursement for qualifying wellness expenses, including gym fees and massage therapy
• Company‑paid basic life insurance, with optional additional coverage available
• Annual company performance bonus opportunity
• Additional benefits and benefit levels that grow with tenure