Revenue Cycle Specialist

ABOUT SPRINTER HEALTH At Sprinter Health, our mission is reimagining how people access care by bringing it directly to their homes. Nearly 30% of patients in the U.S. skip preventive or chronic care simply because they can't get to a doctor's office. For many, the ER becomes their first touchpoint with the healthcare system—driving over $300B in avoidable costs every year. By using the same technologies that power leading marketplace and last-mile platforms, we deliver care where people are, especially those who need it most. So far, we've supported more than 2 million patients across 22 states, completed 130,000+ in-home visits, and maintained a 92 NPS. Our team of clinicians, technologists, and operators have raised over $125M to date investors like a16z, General Catalyst, GV, and Accel and enjoy a multi-year runway. THE ROLE We are looking for a Revenue Cycle Specialist to own the front and back ends of our billing cycle — pre-submission claim scrubbing, rejection resolution, and accounts receivable reconciliation. You will serve as the quality gate before claims go out the door, the first responder when they come back rejected, and the owner of payment reconciliation and posting accuracy across assigned payer relationships. This is a wide-scope role that requires fluency across multiple RCM functions and the ability to prioritize across competing queues. WHAT YOU'LL DO AR & Reconciliation (~40% of role): - Reconcile ERA/EOB payments against expected reimbursement; identify and resolve underpayments, overpayments, and missing remittances - Investigate and resolve payment posting flags in the billing system - Maintain AR aging across assigned payer relationships — work buckets by age and priority - Communicate directly with payer representatives to resolve outstanding balance disputes - Coordinate with our RCM platform team on shared AR workqueues — track what the platform owns vs. what is handled internally Claim Submission & Pre-submission QA (~35% of role): - Perform pre-submission claim scrubbing — catch errors in demographics, eligibility, authorization, coding completeness, and payer-specific requirements before submission - Verify patient eligibility and benefits across assigned payers prior to claim submission - Validate prior authorization requirements and confirm auth numbers are captured correctly on claims - Flag recurring pre-submission error patterns to the RCM Manager with recommendations for upstream workflow fixes Rejection Resolution (~25% of role): - Resolve claim rejections from our RCM platform and payer portals, including 277 rejection reports and real-time rejection queues - Distinguish between clearinghouse-level fixes and payer-level fixes; coordinate with the platform team accordingly - Maintain a rejection tracking log, tagging by error type, payer, and root cause - Work collaboratively with the Denial Specialists to ensure upstream rejections don't re-enter as downstream denials WHAT WE'RE LOOKING FOR Required: - 3+ years of medical billing experience spanning at least two of the three core functions: AR reconciliation, claim submission/QA, or rejection management - Comfort managing multiple work queues simultaneously and reprioritizing based on aging and volume - Experience working ERA/EOB reconciliation at volume — payer-level batch reconciliation, not just individual claims - Familiarity with 837 claim files, 277 rejection reports, and ERA/835 remittance files - Experience with Medicaid managed care and Medicare Advantage payer requirements - Clearinghouse and RCM platform fluency — experience with leading billing platforms a plus, not required Nice to Have: - Experience resolving capitation or encounter-based payment methodology disputes with payers - Prior experience in a lean or startup RCM environment - Exposure to value-based care or risk-adjusted billing models - CMS-1500 and UB-04 experience across both institutional and professional billing