Remote Revenue Cycle Management Generalist (Canada)

About the Role

Rex.zone seeks a mid to senior level professional experienced in healthcare Revenue Cycle Management (RCM) to manage comprehensive revenue cycle workflows. The position involves executing tasks from eligibility verification through claims processing and denial management while also supporting quality assurance, adhering to Standard Operating Procedures (SOPs), and ensuring training data quality to aid automation projects.

Key Responsibilities

• Manage complete RCM operations including verifying patient eligibility, submitting claims, handling corrections, managing denials, and posting payments.
• Analyze reasons for claim rejections or denials, perform root cause investigations, and coordinate the appeals or corrective procedures.
• Support billing processes such as issuing patient statements, managing adjustments, processing refunds, and handling escalations.
• Monitor claim statuses and remittance details through payer portals and clearinghouses.
• Conduct quality assurance evaluations aligned with SOPs, payer regulations, and compliance checklists, ensuring readiness for audits.
• Maintain and update documentation such as SOPs, templates, and checklists to ensure operational consistency.
• Assist with operational reporting including accounts receivable aging, denial trend analysis, accuracy checks, and turnaround time assessments.

Qualifications

• Mid to senior-level experience spanning various RCM functions with comprehensive end-to-end exposure.
• Deep understanding of claims lifecycles and the ability to interpret Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) documents.
• Proficient in using EMR/EHR platforms and payer portals, demonstrating meticulous attention to detail.
• Capability to strictly follow SOPs, maintain version control, and prepare audit-ready documentation.
• Strong written communication skills, essential for drafting escalation notes and providing feedback during quality assurance processes.

Additional Information

• This is a full-time remote position for candidates residing in Canada.
• Work hours align with North American business hours and may vary by assignment.
• Handling of Protected Health Information (PHI) and Personally Identifiable Information (PII) must comply with strict security protocols.

Compensation

The hourly wage ranges from $30 to $50, determined by the scope of work and experience level.