Finni Health (YC W23)

Revenue Cycle Claims Specialist

Finni Health (YC W23)

full-time

Posted on:

Origin:  • 🇺🇸 United States

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Salary

💰 $78,000 - $85,000 per year

Job Level

Mid-LevelSenior

About the role

  • Monitor and triage claims approaching timely filing limits; coordinate with RCM team to resolve and submit billing
  • Research and resolve payer claim rejections; contact payers to get claims accepted
  • Follow up on claims with no payer response and ensure claims are on file with payers
  • Identify and resolve claims held due to eligibility; obtain updated coverage information as necessary
  • Research root causes of denials, contact payers for clarification, and appeal claim denials within appeal deadlines
  • Manage payer EDI enrollments (ERA, EFT), troubleshoot missing ERAs, and enroll new payers as they become in-network
  • Ensure strict adherence to payer regulations and industry standards (e.g., CMS billing, NCQA Guidelines, Delegated Credentialing)
  • Lead workflow optimization initiatives within RCM and manage projects to maximize reimbursement and minimize denials
  • Contribute to development and implementation of processes for billing, claims processing, revenue collections, and cash posting
  • Collaborate with product, provider success, compliance, HR, finance, and other teams to align RCM efforts with business objectives
  • Adapt to evolving responsibilities and projects as Finni Health grows and the RCM landscape changes

Requirements

  • 5+ years of relevant experience in revenue cycle management, RCM operations, or related roles
  • Proven ability to work effectively within a team and independently drive RCM initiatives
  • Deep understanding of the full revenue cycle including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance (e.g., CMS billing)
  • Strong analytical and problem-solving skills to analyze RCM data, identify trends and root causes, and implement data-driven solutions
  • Demonstrated expertise in process optimization and driving continuous improvements
  • Excellent written and verbal communication skills and proven ability to collaborate with internal teams and external stakeholders (payers, vendors, providers)
  • Exceptional organizational and time-management skills, with the ability to manage multiple priorities in a fast-paced environment
  • Proficiency with Google Suite, Slack, CRM/support software, and EHR/RCM management tools
  • Passion for Finni’s mission to democratize autism care and adaptability in a dynamic startup environment