Revenue Cycle Pro: Claims & Reimbursement

EMS Management & Consultants, Inc.; Clemmons (NC); Hybrid; USD 23,000 - 28,000; Full time

Benefits offered by this job

Discretionary bonus

Health coverage

Retirement plan

Paid time off

Job summary

EMS Management & Consultants, Inc. is seeking a Revenue Cycle Specialist to review and process health insurance claims across the revenue cycle, ensuring timely, compliant processing and maximized reimbursement for clients.

The role requires 1–2 years of claims processing experience, strong analytical abilities, and proficiency in EMS|MC billing software and Microsoft Office. This position may support hybrid or remote work in the United States.

Qualifications

• High School Diploma.
• 1–2 years of experience processing health insurance claims and/or denials or other healthcare accounts receivable experience, or 1–2 years medical billing experience or at least 1 year EMS billing experience.
• Ability to holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though.
• Ability to organize, prioritize and multi-task.
• Ability to learn, understand, and work within specific compliance, client, and payer requirements.
• Approach all tasks, duties, and interactions with an attitude of continuous improvement.
• Demonstrated understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability, and tertiary payment methods.
• Willing and able to adapt to changes in work environment, procedures, priorities, and job duties.
• Ability to function well within a cross-functional team setting and independently.
• Strong critical thinking and analytical skills and attention to detail.
• Proficient in Microsoft Office programs.
• Proficiency in English is necessary for job-related communication, including understanding policies, writing correspondence, and engaging with colleagues or clients.

Responsibilities

• Monitor client performance to maximize reimbursement and identify revenue delays.
• Provide proactive feedback on workflows, trends, and payer regulations.
• Initiate timely communication to payers to resolve issues with staff.
• Prioritize and process rejections, denials, appeals, and follow-up per SOPs and SLAs.
• Work independently to define problems and drive timely resolution.
• Collaborate with Supervisor Claims Management and onshore/offshore teams to maximize reimbursement.
• Apply big-picture thinking and continuous improvement to client performance.
• Measure outcomes against client commitments and address barriers.
• Stay updated on industry changes and regulations to ensure compliance.
• Build strong internal and external relationships through customer service.

Skills

Healthcare claims processing

HIPAA compliance

Microsoft Office

Analytical thinking

Multi-tasking

English proficiency

Communication

Education

High School Diploma

Tools

EMS|MC billing software

Job description

EMS Management & Consultants, Inc. is seeking a Revenue Cycle Specialist to review and process health insurance claims across the revenue cycle, ensuring timely, compliant processing and maximized reimbursement for clients.

The role requires 1–2 years of claims processing experience, strong analytical abilities, and proficiency in EMS|MC billing software and Microsoft Office. This position may support hybrid or remote work in the United States.