Open Doors ABA is hiring a Revenue Cycle Claims Specialist to play a critical role in optimizing our revenue cycle operations. At Finni Health, you will be responsible for claims triaging, resolving payer rejections and denials, managing payer EDI enrollments, ensuring compliance, and driving operational efficiency, all in service of our mission to democratize autism care and empower providers.

What You'll Do

Monitor claims approaching timely filing limits and alert the RCM team.
Resolve payer claims rejections by researching root cause, calling the payer, and getting claims accepted.
Follow up on claims with no payer response and ensure claims are on file.
Identify root cause of claims held due to eligibility and work with teams to obtain updated coverage.
Research root cause of claim denials, contact payers for clarification, and appeal denials within deadlines.
Manage payer EDI enrollments (ERA, EFT), troubleshoot issues, and enroll with new in-network payers.
Ensure strict adherence to payer regulations, industry standards, and internal policies.
Lead workflow optimization initiatives and manage projects for continuous process improvement.
Contribute to development and implementation of processes for billing, claims processing, collections, and cash posting.
Collaborate with product, provider success, compliance, HR, finance, and other teams to align RCM efforts.
Adapt and take on evolving responsibilities and projects as the company grows.

What We're Looking For

5+ years of relevant experience in revenue cycle management, RCM operations, or related roles.
Strong understanding of RCM processes, including billing, claims, collections, denial appeals, and accounts receivable management.
Proven ability to work effectively within a team environment and independently drive RCM initiatives.
Deep understanding of the full revenue cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance.
Strong ability to analyze complex RCM data, identify trends and root causes, and implement data-driven solutions.
Demonstrated expertise in identifying inefficiencies and driving process improvements.
Excellent written and verbal communication skills, with ability to collaborate with internal teams and external stakeholders.
Exceptional organizational and time management skills, with ability to manage multiple priorities in a fast-paced environment.
Proficient in Google Suite, Slack, CRM/support software, and EHR/RCM management tools.
Passion for Finni’s mission to democratize autism care and empower providers.
Comfortable thriving in a dynamic, fast-paced startup environment and navigating ambiguity.

Nice to Have

Experience in an early-stage startup, behavioral or mental health, or healthcare tech.
Experience with various EMR/EHR work queue management within RCM.