About this role
We are looking for a highly skilled and strategic Senior RCM Specialist to join our team. This role will play a critical part in driving operational excellence within our revenue cycle with a particular focus on our rapidly evolving Enterprise accounts.
The ideal candidate brings deep experience in revenue cycle operations and coding, along with strong knowledge of insurance payer systems and reimbursement processes. They are confident in leading cross-functional collaboration and can represent the RCM team with clarity and authority. You’ll help us solve complex billing issues, optimize claims performance, and protect the integrity of our operations as we scale.
What you’ll Do
- Take ownership of RCM operations for our Enterprise accounts, leading claim resolution and workflow optimization efforts.
- Serve as a key RCM point of contact in cross-functional meetings, representing the team in discussions with Product, Clinical, Customer Success, Implementation, and external partners.
- Oversee escalated claim and coding issues, including working directly with payers, vendors, and providers to resolve denials and rejections.
- Collaborate with internal clinical and operations teams to improve documentation quality, support proper coding, and reduce avoidable denials.
- Supervise and guide vendor relationships, including coding and denial management partners, with a focus on quality and compliance.
- Lead Enterprise-focused initiatives related to new care models, coding strategies and opportunities to optimize billing processes for complex accounts.
- Stay current on payer-specific coding regulations and trends that impact Enterprise clients, and bring forward proactive solutions to address evolving policies and compliance risks.
- Provide targeted support for Enterprise workflows, including documentation and process development, while serving as a resource to the broader team as needed.
- Assist as needed on RCM for our direct-to-consumer telehealth business, including compliance and reimbursement for commercial and Medicare lines of business
What you bring
- 5+ years of progressive experience in Revenue Cycle Management, including claim resolution, coding, and payer engagement.
- Proven experience navigating Enterprise accounts and complex payer policies, particularly in telehealth or digital healthcare environments.
- Expertise in coding compliance, denial management, and provider education.
- Strong understanding of health plan reimbursement guidelines
- Experience working cross-functionally with clinical teams and external vendors.
- Ability to think strategically and operationally—balancing day-to-day tasks with long-term improvement initiatives.
- Excellent communication and documentation skills.
- Experience managing sensitive workflows requiring discretion, system access, and domain expertise.
- Experience supporting and interfacing with enterprise customers and internal collaborators such as customer success teams
Certifications (Preferred)
Certified Professional Coder (CPC) from AAPC or equivalent accredited certification.
Who we are
Transcarent and Accolade have come together to create the One Place for Health and Care, the leading personalized health and care experience that delivers unmatched choice, quality, and outcomes. Transcarent’s AI-powered WayFinding, comprehensive Care Experiences – Cancer Care, Surgery Care, Weight – and Pharmacy Benefits offerings combined with Accolade’s health advocacy, expert medical opinion, and primary care, allows us to meet people wherever they are on their health and care journey. Together, more than 20 million people have access to the combined company’s offerings. Employers, health plans, and leading point solutions rely on us to provide trusted information, increase access, and deliver care.
We are looking for teammates to join us in building our company, culture, and Member experience who:
- Put people first, and make decisions with the Member’s best interests in mind
- Are active learners, constantly looking to improve and grow
- Are driven by our mission to measurably improve health and care each day
- Bring the energy needed to transform health and care, and move and adapt rapidly
- Are laser focused on delivering results for Members, and proactively problem solving to get there
Total Rewards
Individual compensation packages are based on a few different factors unique to each candidate, including primary work location and an evaluation of a candidate’s skills, experience, market demands, and internal equity.
Salary is just one component of Transcarent's total package. All regular employees are also eligible for the corporate bonus program or a sales incentive (target included in OTE) as well as stock options.
Our benefits and perks programs include, but are not limited to:
- Competitive medical, dental, and vision coverage
- Competitive 401(k) Plan with a generous company match
- Flexible Time Off/Paid Time Off, 12 paid holidays
- Protection Plans including Life Insurance, Disability Insurance, and Supplemental Insurance
- Mental Health and Wellness benefits
Transcarent is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out!
Research shows that candidates from underrepresented backgrounds often don’t apply unless they meet 100% of the job criteria. While we have worked to consolidate the minimum qualifications for each role, we aren’t looking for someone who checks each box on a page; we’re looking for active learners and people who care about disrupting the current health and care with their unique experiences.
Top Skills
What We Do
Transcarent is a health and care experience company that makes it easy to get the high-quality, affordable health and care that everyone and their families deserve – where and when they want it, on their terms. Transcarent puts health consumers back in charge by directly connecting them with an integrated ecosystem of high-value providers and health solutions, providing transparent information, and offering trusted guidance – in as little as 60 seconds, 24/7/365, from the palm of their hand, often at no cost to Members and at a lower cost to their employer. Transcarent takes accountability for results – offering at-risk pricing models and transparent impact reporting to align incentives towards measurably better experience, better health, and lower costs.
