Website:
mysuperbills.com
Job details:
Senior Revenue Cycle Management (RCM) / Claims Operations Lead — MySuperbills
About MySuperbills
MySuperbills helps patients access out-of-network healthcare by simplifying the reimbursement process. We streamline claim submission, tracking, follow-up and resolution, reducing administrative burden for providers and making it easier for patients to use their out-of-network benefits. We are an early-stage startup building technology and operations around a notoriously difficult part of healthcare: getting professional out-of-network claims submitted correctly, received by payers, adjudicated and ultimately resolved.
The Role
We’re hiring a Senior Revenue Cycle Management (RCM) / Claims Operations Lead focused on professional medical claims. This is a hands-on startup role for someone who deeply understands the medical claims lifecycle end-to-end, particularly at the clearinghouse and payer level not just within billing software. You will work directly with the CEO to investigate complex claims, improve our claims operation, identify recurring failure points and build repeatable workflows.
You should be comfortable with:
- 837P professional claims and clearinghouse workflows
- Claim submissions, rejections and 277CA responses
- Payer claim status, follow-up and escalation
- Adjudication and 835 ERAs
- Denials, corrected claims and resubmissions
- CPT, ICD-10, modifiers, POS, diagnosis pointers, provider/NPI and payer-related claim issues
- Reviewing and troubleshooting X12 and JSON claim data
- Diagnosing claims that were accepted by a clearinghouse but are missing, stuck or denied at the payer
- Out-of-network professional claims, including payer-specific OON rules and reimbursement issues
- OON provider registration and payer enrollment, including NPI/TIN setup, payer portals, clearinghouse enrollment, EFT/ERA and enrollment-related claim rejections
- Identifying denial and rejection patterns and turning them into operational improvements
- Documenting claims workflows, payer-specific rules and escalation procedures
You will also help us establish and monitor key claims operations metrics, identify recurring payer issues and serve as the escalation point for difficult claims. An immediate priority will be to help hire, onboard and manage a junior claims specialist who will handle payer calls, status follow-ups and day-to-day claim work.
What We’re Looking For
- Significant experience with US medical claims and Revenue Cycle Management
- Direct experience troubleshooting claims at the clearinghouse and payer level
- Strong working knowledge of 837P, 277CA and 835 transactions
- Ability to read and troubleshoot X12 and/or JSON claim files
- Experience working with clearinghouses and payer portals
- Strong understanding of professional medical billing and payer rules
- Experience with out-of-network claims strongly preferred
- Experience managing, training or mentoring junior claims staff
- Strong analytical and problem-solving skills
- Comfortable working in a fast-moving startup environment where you will both do the work and build the process
This is initially a contract position, starting immediately. Remote candidates are welcome, including candidates based in India. The role requires meaningful overlap with US Eastern Time.
How to Apply
Please apply only if you have direct experience troubleshooting claims at the clearinghouse/payer level.
To help us identify candidates with the right experience, please include:
- How many years of US medical claims / RCM experience do you have?
- Have you worked directly with 837P, 277CA and 835 files in X12 and/or JSON format? Please briefly describe.
- Which clearinghouses have you worked with?
- Give one example of a difficult rejected, stuck or denied claim that you personally diagnosed and resolved.
- What experience do you have with out-of-network claims and provider enrollment/registration?
- Have you managed or trained junior claims staff?
- What hours can you overlap with US Eastern Time?
Please start your message with “837P CLAIMS” so we know you read the full posting.
If your experience is primarily data entry, charge posting, payment posting, or submitting claims through an EHR without investigating clearinghouse and payer-level issues, this role is probably not the right fit.
Click on Apply to know more.
