{"id":2069989,"url":"https://alion.io/job/firstsource-sr-revenue-cycle-billing-specialist","title":"Sr. Revenue Cycle Billing Specialist","company":{"id":1795846,"name":"Firstsource","domain":"firstsource.com","url":"https://alion.io/company/firstsource","size_band":"201-500","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"SuccessFactors","truth_index":null},"role":"Finance","role_family":"Finance","seniority":"senior","employment_type":null,"work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":52000,"max_usd":101000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":932},"experience_years_min":2,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false}],"status":"live","first_seen_at":"2026-10-06T02:00:00Z","employer_posted_date":"2026-10-06","last_verified_at":"2026-10-22T01:25:03Z","board_verified":true,"closed_at":null,"days_open":17,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":17},"description":"Role Description\nThe Revenue Cycle Denials Representative is responsible for managing and resolving denied Professional Billing (PB/CMS-1500) and/or Hospital Billing (HB/UB-04) claims. This role identifies root causes of denials, executes appeals and corrective actions, and collaborates with internal teams to prevent future denials. The ideal candidate has hands-on experience with CARC/RARC denial codes, Epic denial work queues, and payer-specific appeal requirements across Medicare, Medicaid, and commercial payers.\nRoles & Responsibilities\nDenial Review & Resolution - PB & HB\nReview and analyze denied PB (CMS-1500 / 837P) and HB (UB-04 / 837I) claims to determine root causes and appropriate resolution strategies.\nAnalyze account history and all previous actions in Epic prior to taking the next action step to resolve the claim.\nWork claims across all top denial categories including, but not limited to: No Authorization, Timely Filing, Coordination of Benefits (COB), Medical Necessity, Additional Documentation Requests (ADR), Bundling (NCCI edits), and Duplicate Claims.\nInterpret CARC and RARC codes on 835 ERA / EOB remittance data for both PB and HB claims to determine the correct resolution path.\nUnderstand when claim corrections, rebilling (837P or 837I), or void-and-replace actions are appropriate.\nEscalate claims with payers for resolution when processing is inaccurate or delayed.\nAppeals & Reconsiderations\nPrepare and submit appeals and reconsideration requests in compliance with payer-specific guidelines and deadlines for both PB and HB denied claims.\nAttach appropriate clinical documentation, medical records, authorization references, and justification letters to support appeal submissions.\nMeet appeal deadlines for Medicare, Medicaid, and commercial payers in accordance with payer-specific requirements.\nTrend Identification & Prevention\nIdentify denial trends across PB and HB claim types and collaborate with coding, clinical, and billing teams to implement corrective actions.\nMonitor payer policy and regulatory changes (Medicare LCDs/NCDs, Arkansas Medicaid updates) to proactively prevent denials.\nAssist in developing best practices and training materials for PB and HB denial management and prevention.\nPayer & System Knowledge\nNavigate Epic denial and underpayment work queues for both HB and PB modules; document all denial actions and resolutions.\nUtilize payer portals (Availity, Arkansas DHS, Medicare.gov, and commercial payer sites) to research denial reasons and submit appeals.\nUtilize resources provided by the client to promote accuracy and resolve claims in accordance with client expectations.\nCompliance & Documentation\nMaintain thorough documentation of denial reasons, appeal actions, and resolutions in Epic.\nEnsure compliance with federal, state, and payer regulations as well as hospital and physician practice policies.\nCommunicate effectively with insurance representatives and internal leaders to expedite resolution and improve processes.\nAlways maintain confidentiality of patient and account information (HIPAA).\nAdhere to prescribed policies and procedures outlined in the Employee Handbook and Code of Conduct.\nMaintain awareness of and actively participate in the Corporate Compliance Program.\nMaintain a confidential and orderly remote work area.\nMeet specified goals and objectives assigned by management and/or the Client.\nAssist with other projects as assigned by management.\nExpected / Key Results\nDeliver high levels of client and patient satisfaction (CSAT)\nAchieve quality scores per defined process standards\nDeliver defined process-specific metrics (e.g., denial resolution rate, overturn rate, appeal success rate)\nAdherence to regulatory compliance requirements\nSchedule adherence\nPreferred Educational Qualifications\nHigh school diploma or equivalent required\nAssociate’s or Bachelor’s degree in Health Information Management, Business, or related field preferred\nCPC, CPMA, CRCR, or CHFP certification a plus\nPreferred Work Experience\n2+ years of experience in healthcare revenue cycle, denial management, or claims resolution\nDemonstrated experience working PB (CMS-1500 / 837P) and/or HB (UB-04 / 837I) denials\nPrior experience with Epic denial work queues strongly preferred\nFamiliarity with Medicaid, Medicare, and commercial payers preferred\nExperience interpreting CARC/RARC codes and 835 ERA / EOB remittance data\nKnowledge of NCCI edits, LCD/NCD policies, and authorization/pre-certification workflows\nCompetencies & Skills\nStrong knowledge of PB and HB denial workflows, appeal processes, and payer-specific requirements\nProficiency with Epic (HB and/or PB modules, denial work queues, claim correction, void-and-replace, and rebilling)\nSolid understanding of CARC/RARC denial reason codes and how to act on them for PB and HB claims\nAbility to read and interpret 835 ERA / EOB remittance advice for both PB and HB claims\nKnowledge of payer portals including Availity, Arkansas DHS, and commercial payer sites\nCompetent in working and communicating effectively with payers, patients, colleagues, and management - both in-person and via remote virtual platforms\nConsistently maintains a courteous and professional demeanor\nSelf-motivated with the ability to stay focused and productive with minimal supervision\nProactive initiative and creative problem-solving in carrying out job responsibilities\nAbility to prioritize multiple tasks through effective time management and organizational skills\nProficiency in PC operations; ability to type at a rate of 30-40 words per minute\nBenefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off.\nWe are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.\nNot Accepting Referrals","description_format":"text","description_chars":5988,"description_truncated":false,"requirements":{"experience_years_min":2,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":true},"security_clearance":false,"languages":[]},"benefits":["401k plan"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Artificial Intelligence","Health Care","Professional Services"],"lifecycle":[{"event":"open","at":"2026-10-08T06:07:41Z"}],"visa":[],"liveness":{"score":47,"band":"ok","label":"Likely open","p_open":1,"p_active":0.861,"p_room":0.55,"age_days":17,"expected_fill_days":14,"reasons":["conf:28","velocity","win:tail"],"computed_at":"2026-10-23T05:54:15Z"},"pay":null,"html_url":"https://alion.io/job/firstsource-sr-revenue-cycle-billing-specialist","json_url":"https://alion.io/job/firstsource-sr-revenue-cycle-billing-specialist.json","meta":{"generated_at":"2026-10-23T17:29:53Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":26604,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-24T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":1795846},"rest":"https://alion.io/mcp/rest/get_company?id=1795846"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Ffirstsource-sr-revenue-cycle-billing-specialist"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Ffirstsource-sr-revenue-cycle-billing-specialist"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Ffirstsource-sr-revenue-cycle-billing-specialist"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/firstsource-sr-revenue-cycle-billing-specialist\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Ffirstsource-sr-revenue-cycle-billing-specialist"}]}