Job Description & Details
This is a hands-on functional leadership role focused entirely on fixing and optimizing payer-facing revenue cycles. If you know the ins and outs of claim-to-cash workflows and are tired of revenue leakage due to messy payer interactions, this contract-to-hire position gives you the runway to actually fix those systemic gaps.
What You'll Actually Be Doing
Expect to spend your days knee-deep in claim-to-cash workflows, analyzing everything from initial 837 submissions to stubborn denials and remittance reconciliation. You will be auditing clearinghouse behaviors, evaluating CARC and RARC codes, and dissecting why claims get stuck in adjudication. Your main goal is to figure out where the money is leaking out of the system and build tighter, more efficient processes to recover it.
The Core Tech Stack
You need absolute mastery over healthcare transaction sets like 837P, 837I, and 835 ERA processing, alongside deep familiarity with major EHR platforms like Epic, Cerner, or Meditech. The team is relying on your expert-level understanding of payer rules, clearinghouse operations, and denial management to automate variance tracking and clean up their reimbursement pipelines.
Interview Expectations
The hiring team is going to test your practical grit by asking you to walk through a scenario where a specific payer cohort experiences a sudden spike in denials and payment variances. They want to hear your step-by-step root-cause analysis, covering everything from front-end eligibility checks to back-end remittance reconciliation. Another classic question you will face revolves around handling complex Coordination of Benefits and timely filing limits; they are secretly testing your ability to balance technical transaction data with strategic stakeholder management.
Application Advice
Skip the generic corporate summary and immediately put your 10+ years of healthcare RCM experience front and center on your resume. Make sure to explicitly include keywords like 837P/837I, 835 ERA, CARC/RARC codes, and clearinghouse operations so you easily clear the ATS filters. Emphasize tangible past projects where you successfully reduced revenue leakage or automated denial workflows, as that is the exact currency this hiring manager cares about.