Revenue Cycle Billing Specialist (Remote, Remote, US)

Role Description The Revenue Cycle Follow-Up Representative is responsible for ensuring timely and accurate follow-up on both Professional Billing (PB/CMS-1500) and/or Hospital Billing (HB/UB-04) claims. This role manages accounts receivable, resolves unpaid and underpaid claims, and drives reimbursement from government and commercial payers. The ideal candidate has strong knowledge of 837P/837I transaction sets, EOB/ERA reconciliation, and payer-specific follow-up requirements. Roles & Responsibilities Claim Follow-Up – PB & HB Monitor and follow up on outstanding PB (CMS-1500 / 837P) and HB (UB-04 / 837I) claims via phone calls, payer websites, and Epic work queues to ensure timely reimbursement. Investigate and resolve unpaid, underpaid, and rejected claims by working with insurance providers and internal departments. Analyze account history and all previous actions in Epic prior to taking the next action step to resolve the claim. Identify payer trends and payment discrepancies across both PB and HB claim types and escalate findings to leadership. Understand when claim corrections, rebilling (837P or 837I), and resubmissions are applicable. Escalate claims with payers for resolution on inaccurate or delayed claim processing. Appeals & Reconsiderations Submit reconsiderations and/or appeals for both PB and HB claims with appropriate attachments, documentation, and clinical justification. Adhere to payer-specific appeal deadlines and formatting requirements for