Medical Billing Specialist - Revenue Operations

Job description

Role Overview 

We are hiring a Medical Billing Specialist with deep experience in healthcare billing and a working knowledge of accounting and operational reporting. This role is responsible for executing and reconciling billing activity end-to-end, with a focus on Medicaid and national insurance payers. 

This position also plays a critical role in ensuring data integrity across billing, clinical, and operational systems, working closely with data, clinical, and onboarding teams to maintain accurate and timely inputs that directly impact billing, collections, and payouts. 

Key Responsibilities

Medical Billing & Claims Management 

• Manage full-cycle medical billing: charge entry, claims submission, payment posting, and denial resolution 

• Submit and track claims through clearinghouses and payer-specific payment portals 

• Work primarily with Medicaid and national insurance companies 

• Investigate and resolve denials, rejections, and underpayments 

• Maintain accurate billing records 

Accounts Receivable & Reconciliation 

• Reconcile AR across billing systems and financial records 

• Identify discrepancies between expected reimbursements and actual payments 

• Own AR aging review and resolution 

• Support month-end close with validated AR balances 

Payroll & Payout Support 

• Validate payroll inputs tied to billing activity 

• Reconcile payroll/payout data against billing records 

• Flag inconsistencies impacting compensation 

Cross-Functional Data Collaboration 

• Partner with data teams on data accuracy and pipelines 

• Work with clinical teams on documentation and coding validation 

• Collaborate with onboarding teams for correct system setup 

• Identify upstream data issues and drive resolution 

Data Analysis & Reporting 

• Analyze billing and AR data for trends and issues 

• Produce recurring reports and support ad hoc analysis 

Business Intelligence & Systems 

• Utilize reporting dashboards from Business Intelligent tools for data and daily operation 

• Improve reporting and billing workflows 

• Collaborate with data teams to improve the company data reports and data quality

Job requirements

Qualifications

Required 

• 5+ years of medical billing experience (Medicaid + national payers) 

• 3+ years of accounting or AR reconciliation experience 

• Experience with clearinghouses and payment portals 

• Strong revenue cycle knowledge 

• Cross-functional collaboration experience 

• Excel proficiency 

• Business Intelligent tool experience 

• Payroll proficiency 

Additional Requirements 

• Ability to trace data issues across systems 

• Experience working with data teams 

• Understanding of billing data dependencies 

• Ability to translate operational issues into data requirements 

• Basic SQL preferred

How We Operate - Non-Negotiable:

"Insanely Great" for Families - Delivered Now:

Forget just 'satisfaction'. We deliver support that makes caregivers feel loved and seen. Understand their pain, anticipate their needs, and solve them – fast. The standard is "Insanely Great," period. Anything less slows us down and fails our families.

Speed is King - Ruthless Focus is the Key:

Velocity comes from focus. Kill distractions. We concentrate all firepower on the #1 critical objective until it's done. Then we attack the next one. Decide what not to do and cut it ruthlessly. Being a mile wide and an inch deep is failure. Move the needle now.

Raise the Bar: Crush Mediocrity:

Mediocrity is poison. It kills speed, morale, and companies. We hunt it down and eliminate it. Good enough is never good enough. Demand A-Player performance from yourself and everyone around you. Own your shit. Deliver excellence, fast. No excuses, no passengers.

The Speed Algorithm: Question. Delete. Simplify. Accelerate.

This is how we build momentum: Question every requirement – who asked? why? Delete ruthlessly – parts, processes, bureaucracy. If you don't add 10% back later, you didn't cut enough. Simplify what's left. Then, accelerate cycle time like hell. Challenge everything. "It can't be done" means "You haven't figured it out yet. Go do it." Break bottlenecks, find shortcuts, remove friction.

Act Like Owners - Bold Bets, Fast Action:

This is your company. Own the mission, own the results. Don't wait for permission – take initiative. Make bold bets that can leapfrog progress for our families. Act decisively. Move fast. If you stumble, learn faster and go again. Bias for action is everything.

The Bottom Line:

We are building something vital and doing it at lightning speed. This requires intensity, focus, and a relentless drive to execute. If reading this makes you want to jump up and build faster, welcome to Entyre. If not, get out of the way.

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