Revenue Cycle Consultant

Revenue Cycle Management (RCM) Specialist – NSA IDR & Compliance

Location: Dallas, TX or Tampa, FL

Position Summary

We are seeking an experienced Revenue Cycle Management (RCM) Specialist with expertise in No Surprises Act (NSA) Independent Dispute Resolution (IDR) processes and healthcare compliance. This role is responsible for managing billing operations, resolving payer disputes, ensuring regulatory adherence, and optimizing reimbursement across the full revenue cycle.

Key Responsibilities

• Manage end-to-end revenue cycle functions including medical billing, claims submission, payment posting, denial management, and collections
• Handle payer disputes and escalations, including underpayments, denials, and out-of-network reimbursement issues
• Lead and manage NSA IDR cases, including documentation, submission, tracking, and resolution
• Analyze denied or underpaid claims and initiate appeals and dispute resolution processes to maximize reimbursement
• Ensure compliance with federal/state regulations (NSA, HIPAA, payer guidelines) and internal policies
• Monitor accounts receivable, identify billing discrepancies and revenue leakage, and implement corrective actions
• Collaborate with payers, providers, and internal teams to resolve complex billing issues and disputes
• Maintain detailed documentation and audit trails to support compliance and dispute resolution
• Support process improvement initiatives to enhance billing accuracy, dispute outcomes, and overall RCM performance

Required Qualifications

• 3–5 years of experience in Revenue Cycle Management, medical billing, or healthcare finance
• Direct experience with NSA IDR processes and payer dispute resolution
• Strong understanding of billing workflows, claims lifecycle, denials, appeals, and reimbursement methodologies
• Knowledge of CPT, ICD-10 coding, and payer policies
• Experience with EHR/RCM systems and payer portals
• Strong analytical and problem-solving skills with attention to detail

Preferred Qualifications

• Experience in compliance, audits, or regulated healthcare environments
• Certifications such as CRCR, CPC, or RCMS
• Familiarity with RCM analytics or automation tools

Key Skills

• Medical billing & claims management
• Dispute resolution & appeals (including NSA IDR)
• Revenue recovery & denial management
• Compliance & regulatory knowledge
• Data analysis & reporting
• Cross-functional communication

Work Authorization

Candidates must be legally authorized to work in the United States on a full-time basis without the need for current or future sponsorship.