US RCM Specialist

IMPORTANT:
1. Please read until the end. Specific application instructions are provided at the end of this job posting.
2. This is a specialized role. In depth expertise, knowledge, and experience of US RCM, including critical thinking and business analysis, and close working dynamics with senior leadership, are required. Only apply if you meet this criteria.

About Rocket Doctor

Rocket Doctor is a cloud-based telehealth company bringing advanced medical care into homes across North America. We are a passionate group of medical professionals, technical experts, and patient care professionals who believe everyone deserves access to quality healthcare.


About the Role

We are building our US Revenue Cycle Management (RCM) operations in-house and are looking for an experienced RCM Specialist to become one of the first members of the team.

This is a hands-on, generalist RCM role suited for someone who understands the full lifecycle of US professional billing and is comfortable working across multiple areas of the revenue cycle rather than specializing in only one function.

Because the operation is starting at a relatively small scale, the successful candidate will initially touch several areas—including eligibility, coding review, claim submission, rejections, denials, A/R follow-up, payment posting, and reconciliation. As the operation grows, these responsibilities may eventually be divided among more specialized team members.

You do not need to be an expert in every area of RCM. We are looking for someone with solid practical experience, strong fundamentals, and enough end-to-end understanding to identify issues, troubleshoot them, and help us establish reliable workflows.


Key Responsibilities

Perform insurance eligibility and benefits verification, including review of patient demographics, insurance information, coordination of benefits (COB), and payer requirements.
Review encounters for billing readiness and identify missing or inconsistent information before claim submission.
Review CPT, ICD-10, modifiers, place of service, and other claim information for general accuracy and completeness.
Perform basic coding review and escalate complex coding or documentation questions when appropriate.
Prepare and submit professional claims through a practice management system and/or clearinghouse using CMS-1500 / 837P workflows.
Monitor clearinghouse responses and correct claim rejections, validation errors, and other submission issues.
Track outstanding claims and conduct A/R follow-up through payer portals, phone calls, and other available channels.
Review denied or underpaid claims, interpret EOBs, ERAs, CARC/RARC codes, determine root causes, and take appropriate corrective action.
Correct and resubmit claims, prepare reconsiderations or appeals, and follow through until resolution.
Post insurance payments, adjustments, patient responsibility, and other transactions from 835/ERA and EOBs.
Assist with secondary billing and coordination of benefits when applicable.
Reconcile payments and identify discrepancies between claims, remittances, and expected reimbursement.
Maintain clear documentation of claim activity and follow-up actions.
Help identify recurring billing issues and recommend improvements to reduce preventable rejections and denials.
Assist in developing SOPs, job aids, checklists, and quality standards as we build the RCM operation.
Participate in quality reviews and help ensure processes are consistently followed.
Work closely with Operations, clinical teams, finance, and other stakeholders to resolve billing-related issues.
Support additional RCM functions as needed while the operation continues to grow.


Required Experience

At least 3 years of hands-on experience in US healthcare Revenue Cycle Management, medical billing, or professional billing.
Practical experience across several stages of the revenue cycle rather than experience limited to only one highly specialized function.
Experience with US outpatient and/or professional claims.
Working knowledge of:
Eligibility and benefits verification
Patient demographics and insurance validation
Coordination of Benefits (COB)
CPT and ICD-10
E/M coding fundamentals
Modifiers and place-of-service requirements
CMS-1500 / 837P claims
Clearinghouse workflows
Claim rejections and denials
A/R follow-up
EOB and ERA interpretation
CARC/RARC denial codes
835 remittance files
Payment posting and contractual adjustments
Experience working with payer portals and contacting US insurance companies regarding claim status and resolution.
Strong attention to detail and ability to identify discrepancies in claims, payments, and patient insurance information.
Strong written communication and documentation skills.
Preferred Experience
Experience supporting telehealth, primary care, outpatient physician practices, or similar professional services.
Experience working with Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
Experience with coding review or medical coding in addition to billing.
CPC, CCS-P, or another recognized coding certification is an advantage but not required.
Experience helping build or improve RCM workflows, SOPs, or QA processes.
Experience joining a new or growing RCM operation where processes were still being established.
Familiarity with practice management systems, clearinghouses, and ERA/EFT enrollment processes.


This role will be a particularly good fit for someone who:

Understands how the different parts of the revenue cycle affect one another.
Can investigate a claim problem instead of simply passing it to another department.
Is comfortable wearing multiple hats while the team is small.
Knows when they can resolve an issue independently and when specialized expertise is needed.
Enjoys building processes rather than only working within an already mature operation.
Can balance productivity with accuracy and compliance.
Is organized and comfortable keeping track of claims requiring continued follow-up.
Can recognize recurring problems and help turn solutions into repeatable processes.
Wants the opportunity to grow alongside an RCM operation as more specialized roles and leadership positions are added.


What Makes This Role Different

This is not a traditional production role where you will perform the same RCM task throughout the day.

You will be joining at the early stage of building an in-house US RCM operation, which means you will have visibility across the revenue cycle and an opportunity to help shape how the operation works.

Initially, the team will be small and responsibilities will be broad. As claim volume and the team grow, functions such as eligibility, coding, claim submission, denials, A/R, payment posting, QA, and training may eventually develop into dedicated roles.

For someone with strong RCM fundamentals and a builder mindset, this is an opportunity to play an important role in establishing that foundation.

If interested, please include a link to your updated resume as well as link to a 3-5 minute video introduction to your message/application and send it to jobs [at] rocketdoctor [d0t] io.


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