Billing Operations Specialist

About Us

At Alteva RCM, we're dedicated to helping healthcare providers thrive through expert revenue cycle management, strategic insight, and innovative solutions. We're always looking for passionate, driven professionals who want to make a meaningful impact, grow their careers, and be part of a collaborative team committed to excellence.

Position Summary

The Billing Operations Specialist serves as a key operational partner to the Billing Operations Manager and Billing Department leadership, supporting the day-to-day execution of billing operations across claim intake, billing, QA, and coding coordination. This role helps ensure that claim information is received, entered into the billing system, and billed accurately and in accordance with billing and coding guidelines, healthcare regulations, and payer-specific requirements by maintaining the trackers, reporting, documentation, and follow-up that keep workflows visible and on track. The Billing Operations Specialist provides first-line triage of productivity issues, workflow concerns, and escalations, and surfaces data-backed insights to leadership - supporting clean claim submission, reduced rework, and timely reimbursement.

Key Responsibilities

Department Support & Accountability

• Partner with the Billing Operations Manager and Billing Department leadership to manage priorities and support day-to-day execution across billing, claim intake, and QA workflows
• Monitor output, backlog levels, queue health, and operational risks; flag systemic issues to leadership with supporting data
• Provide first-line triage of day-to-day productivity issues and workflow concerns by logging the issue, gathering details, and routing it to the appropriate team lead or the Billing Operations Manager
• Monitor urgent escalations, workflow blockers, and client-impacting issues, exercising sound judgment on when to escalate
• Support staffing, workload management, and capacity assessments by compiling volume, backlog, and coverage data for leadership review
• Support hiring, onboarding, and performance evaluation logistics, including scheduling, scorecards, and interview materials
• Coordinate leadership calendars and meetings; prepare agendas and meeting notes; and capture decisions, action items, owners, and deadlines, following through with stakeholders

Operational Strategy & Process Improvement

• Support alignment of workflows, priorities, and performance standards across all billing and claim intake teams
• Identify bottlenecks, repeated errors, and rework drivers, and bring improvement recommendations to leadership
• Support standardization of workflows, escalation protocols, and quality controls across all billing and claim intake teams
• Build and maintain Excel-based analyses, dashboards, and reports from claims and ticket data exports (e.g., accuracy rates, turnaround time, rework rate, backlog aging) to support leadership decision-making
• Track implementation of client-specific billing rules, provider rosters, tax ID rules, directory billing guidelines, account statuses, and workflow changes
• Maintain billing documentation, including SOPs, workflows, process maps, rollout instructions, tracker standards, and version-controlled reference materials

Compliance & Quality Assurance

• Support adherence to payer requirements, HIPAA regulations, and internal SOPs by maintaining accurate documentation and flagging potential compliance risks to leadership
• Support billing audits, QA activities, and data validation efforts, and compile audit finding trends from QA data
• Track corrective actions for identified errors or audit findings through timely completion

Cross-Functional Collaboration

• Serve as a liaison between Billing Department leadership, the Workflow Manager, Billing Team Managers, Claim Intake Team (CIT) leadership, QA, coding, onboarding, IT/product partners, client service, and other operational teams
• Communicate billing priorities, workflow changes, deadlines, and escalation items clearly and professionally
• Document requirements and track follow-up with IT and product partners on billing platform and ticketing system requests

Key Performance Indicators

• Accuracy and currency of trackers, SOPs, and documentation
• Timeliness and accuracy of leadership reporting and meeting materials
• Action item closure rate and timeliness
• Escalations identified and routed within expected timeframes
• Corrective action tracking and closure timeliness
• Stakeholder satisfaction with coordination and follow-through

Experience & Requirements

• Bachelor's degree or equivalent professional experience.
• 3–5 years supporting billing operations, revenue cycle management, healthcare administration, executive support, or business operations.
• Strong understanding of medical billing workflows preferred, including claim intake, coding handoffs, billing rules, provider rosters, payor requirements, documentation gaps, and claim lifecycle tracking.
• Advanced Excel proficiency (pivots, summaries, charts) and comfort building reports from data exports; proficiency with standard office productivity and collaboration tools; experience with billing, workflow, and reporting systems preferred.
• Exceptional organizational, planning, communication, follow-up, and time-management skills.
• Demonstrated ability to work independently, exercise sound judgment, protect confidential information, and deliver results with minimal supervision.
• Healthcare, revenue cycle management, specialty billing, or professional services experience strongly preferred.

Additional Qualifications

• Working knowledge of HIPAA regulations and healthcare privacy laws; handles protected information with full compliance.
• Takes ownership and consistently follows through on billing priorities, open items, and leadership requests.
• Operates independently while knowing when billing accuracy, client communication, compliance, or workflow risk requires escalation.
• Communicates with professionalism, confidence, clarity, and persistence across billing and cross-functional teams.
• Thrives in a fast-paced billing environment with competing priorities, urgent escalations, and frequent workflow changes.
• Continuously improves processes, documentation, visibility, and accountability so the billing team can work more accurately and efficiently.

Pay Range

$90,000 - $120,000 USD

Benefits

Alteva RCM offers our employees a comprehensive benefits package, including health, dental, vision, employee assistance plan, paid family leave, short-term disability and life insurance. We also provide a 401(k) plan with employer match, flexible spending accounts, employee discount program and an employee referral program.