Revenue Cycle Management

Revenue Cycle Management & Medical Billing Specialist (Remote – South Africa) Location: Remote (based in South Africa) Schedule: 8:00 a.m. – 5:00 p.m. Arizona (MST) Department: Finance / Revenue Cycle Management Effective Date: November About Total Care Connections At Total Care Connections, we're driven by a mission to provide extraordinary care for seniors and adults with disabilities throughout Arizona and Colorado. As one of the fastest-growing home care and home health agencies in the Southwest, our success is built on compassion, professionalism, and an unwavering commitment to excellence. We've proudly been recognized on the INC list for nine consecutive years, and we continue to expand our services with purpose, integrity, and innovation. Position Overview We are seeking an experienced Revenue Cycle Management (RCM) and Medical Billing Specialist to join our growing team on a remote basis from South Africa. This position will play a critical leadership role in ensuring accurate billing, streamlined payment posting, and effective denial management across multiple payors. The ideal candidate will be a hands‑on billing expert and process leader capable of driving our transition to the Waystar clearinghouse, auditing high-volume claims, and optimizing automation within our revenue cycle. If you're confident in your ability to take ownership of complex billing workflows and lead with initiative—not requiring significant training—this is an opportunity to make a meaningful impact within a fast‑paced, mission‑driven organization. Key Responsibilities Lead Implementation of Waystar: Spearhead the setup, configuration, and ongoing management of the Waystar clearinghouse to ensure seamless integration and efficient claim submission. Claims Management: Review, process, and submit2, claims per month across payors including Banner, United Healthcare, TriWest, and Colorado Medicaid. Payment Posting & Reconciliation: Conduct detailed audits of remittance advices to ensure all payments are accurately posted and reconciled. Denial & Underpayment Resolution: Identify, analyze, and resolve claim denials and payment discrepancies by working directly with payors. Process Improvement & Automation: Develop and implement systems to automate and streamline claim submissions, payment posting, and reporting workflows. RCM Oversight: Maintain accountability for clean claim rates, days in A / R, and collection performance metrics. Payer Communication: Serve as the primary liaison with insurance companies to adjudicate payment errors and facilitate timely resolution. Training & Mentorship: Provide practical training and support to internal billing team members to improve accuracy and efficiency. Compliance & Documentation: Ensure all billing activities comply with payer requirements, HIPAA regulations, and internal standards. EVV Systems: Utilize and review Electronic Visit Verification (EVV) data to validate claims and improve billing accuracy (experience preferred). Reporting: Generate reports to track claim volume, payment status, denials, and reconciliation results for leadership review. Qualifications Minimum 3 years of medical billing and RCM experience in home care, home health, or related healthcare environments. Proven ability to manage high-volume claim processing (2, claims / month). Experience implementing or managing clearinghouse platforms (Waystar preferred). Strong understanding of payment posting, reconciliation, and auditing processes. Knowledge of EVV (Electronic Visit Verification) systems (preferred). Skilled in denial management and payer follow-up, including direct contact with insurance representatives. High proficiency in Excel, reporting tools, and RCM software. Exceptional attention to detail, analytical thinking, and problem‑solving abilities. Ability to work independently while aligning with U.S. business hours (Arizona time). Why Join Total Care Connections A mission-driven company with a culture rooted in servant leadership and radical generosity. Opportunity to lead critical RCM and billing initiatives for a top‑ranked home care agency. Collaborative, high‑performance environment that values innovation and accountability. Long‑term growth potential following a successful initial engagement. #J-18808-Ljbffr