Billing Specialist — Special Projects; Part-Time, Temporary

Job Title Billing Specialist
- Special Projects (Part-Time, Temporary) Job   Work From Home Yes Work Remote Yes Work Hybrid Yes Location Hamden, CT, 06517, US Work From Home Remote Hybrid Other Location Description

Ria Health, recognized as the leading national telehealth provider specializing in alcohol use disorder (AUD) treatment, recently raised $12.5 million through a Series B financing led by Peloton Equity. Our existing investors SV Health, BPEA and SOSV also participated in the Series B.

Ria Health will enable patients to achieve long term success in reducing or eliminating their alcohol consumption, and live healthier and happier lives. We are seeking a Billing Specialist
- Special Projects to join our rapidly growing team. Ria Health, recognized as the leading national telehealth provider specializing in alcohol use disorder (AUD) treatment, recently raised $18 million in Series A led by SV Health Investors, LLC. The investment will further the momentum of commercial partnerships that include regional and national health plans, including Anthem Blue Cross Blue Shield, United Health Group Optum, Beacon Health Options, Highmark Health, and Magellan Health.

Join the team that integrates medical care, behavioral support, and technology tools to help members achieve their personal goals in treating alcohol misuse. Ria Health is a Center of Excellence that delivers a Joint Commission accredited program that leverages evidence-based pharmacotherapy, psychosocial support, and an engaging care delivery platform to help members achieve lasting improvements in their quality of life. Ria's published outcomes data set the standard for effectiveness in alcohol treatment.

The Ria program is delivered through telehealth and by a care team of Physicians, Nurse Practitioners, and Coaches with clinical expertise to manage care and outcomes for Ria Health members.

This is a temporary, project-based role focused on executing account resolutions as part of an accounts receivable cleanup initiative. The Director of Revenue Cycle will review and categorize outstanding claim denials into resolution buckets (e.g., write-off, transfer balance to patient, resubmit, appeal). The Billing Specialist will take that guidance and carry out the corresponding actions directly in the RCM system. This role is well suited to someone early in their medical billing career who is detail-oriented, comfortable following defined processes, and eager to build hands-on revenue cycle experience.

The Billing Specialist will report directly to the Director of Revenue Cycle for the duration of the project.

This role supports an accounts receivable cleanup project. The Director of Revenue Cycle will analyze claim denials and assign each account to a resolution category. The Billing Specialist is responsible for executing the assigned action for each account in the RCM system, accurately, consistently, and in a timely manner, to help bring AR to a current, accurate state. This candidate takes pride in their professionalism, accuracy, and attention to detail.

• Review, prioritize, and work aged accounts receivable balances as part of the AR cleanup project
• Communicate, analyze, and reconcile billing and collections issues
• Analyze and resolve claim rejections and denials related to billing
• Flag unclear or unusual accounts to the Director of Revenue Cycle for guidance rather than making independent determinations
• Perform follow-up on all outstanding insurance claims and reconcile over payments
• Maintain a high degree of professionalism in all daily correspondence
• Perform data entry and corrections related to healthcare claims as part of cleanup work
• Navigate practice/billing software systems efficiently to research and resolve account issues
• Assess patient balances to ensure accurate billing and provide follow-up as needed
• Provide regular status updates and reporting on AR cleanup progress to the Director of Revenue Cycle
• Maintain HIPAA guidelines and a high level of discretion due to the sensitivity of information
• Other duties and responsibilities as directed by the Director of Revenue Cycle

• High school diploma required;
  Associate's degree or coursework in a related field a plus
• 0-3 years of experience in medical billing and/or revenue cycle management
• Basic familiarity with medical billing terminology…