Senior Medical Billing & Revenue Cycle Specialist (A-Player Only)
Full-Time | In-Person | The Woodlands, TX
We are a highly specialized, fast-growing dental sleep medicine practice dedicated to changing lives by helping patients finally breathe and sleep at night. We do not offer traditional dentistry — we focus exclusively on treating obstructive sleep apnea for patients who cannot tolerate CPAP.
What we do is meaningful, technical, and incredibly rewarding — and we are building a top-tier administrative and billing team to support our growth.
We are seeking an experienced, high-performing Medical Billing & Revenue Cycle Specialist who takes pride in accuracy, ownership, follow-through, and results.
This is not a routine billing role. This position requires deep experience, confidence with payers, strong clinical understanding, and the ability to protect revenue across the entire lifecycle.
Exceptional candidates with specialty billing, payer contracting, revenue cycle leadership, and advanced payer negotiation experience may be considered above the posted pay range.
THIS ROLE IS IDEAL FOR SOMEONE WHO:
- Owns outcomes, not just tasks
- Understands how authorizations, claims, documentation, and contracts connect
- Is calm, confident, and persistent with insurance companies
- Can explain insurance and patient responsibility clearly and professionally
- Cares deeply about accuracy, ethics, and doing things the right way
- Thrives in a high-standards, no-drama, no-negativity environment
- Takes tasks to the completion, finishes and obtains the desired outcomes
KEY RESPONSIBILITIES Billing, Authorizations & Revenue Cycle Management
- Perform detailed insurance eligibility verification via portals and phone for specific CPT/DME codes
- Accurately document benefits, coverage limitations, and requirements in patient charts
- Prepare clear, accurate out-of-pocket estimates for patients
- Complete and aggressively follow up on prior authorizations via portal, phone, and fax
- Manage GAP waivers / Single Case Agreements, including payer negotiations
- Submit clean claims and maintain a 99%+ paid-claims rate
- Follow up on unpaid or denied claims (30+ days), identify root cause, and resolve efficiently
- Tracks claim history with plans to provide efficiency for future claims
- Conduct full accounts receivable follow-up and reconciliation
- Review clinical documentation to ensure claims meet medical necessity and payer criteria
- Generate patient invoices, superbills, and close claims accurately
- Support patients using HSA/FSA funds with proper documentation
Credentialing & Payer Contract Support
- Complete and manage provider credentialing for new and existing payers
- Support in-network contracting and payer enrollment maintenance
- Keep Availity and all payer portals current, accurate, and functional
Clinical Documentation & Referrals
- Review and interpret medical records and clinical notes from referring providers
- Identify missing documentation required for authorization and claims approval
- Proactively contact referring offices to obtain records while maintaining strong professional relationships
- Understand medical terminology, sleep testing, sleep studies, and DME documentation standards
Patient & Professional Communication
- Confidently explain insurance vs patient responsibility in a calm, transparent, trust-building manner
- Handle financial conversations professionally and compassionately
- Provide exceptional phone etiquette with patients, referring offices, and insurance representatives
- Communicate with clarity, warmth, and authority — even in high-pressure situations
QUALIFICATIONS (NON-NEGOTIABLE FOR A-PLAYERS)
- 5+ years medical billing experience (required)
- Medical Billing Certification (required)
- Proven experience with:
- Prior authorizations
- GAP waivers / SCAs
- Claims submission and follow-up
- Revenue cycle management
- Clinical documentation review
- Strong background in medical terminology and chart review
- High attention to detail with minimal error tolerance
- Advanced computer literacy, fast and accurate typing
- Exceptional organization and workflow management skills
- High emotional intelligence and professionalism
- Kind assertiveness — able to push payers while remaining professional
Preferred Experience:
- DME billing
- Sleep medicine / sleep studies
- Credentialing and payer enrollment
- Account reconciliation
- Specialty medical billing
CULTURE & EXPECTATIONS
We are a small but rapidly growing practice with very high standards.
We value:
- Kindness
- Accountability
- Positivity
- Excellence
- Teamwork
We do not tolerate pessimism, gossip, or complacency. We love what we do, we love our patients, and we love working with people who genuinely enjoy contributing to something meaningful.
WHY JOIN US
- Work in a highly specialized, purpose-driven medical practice
- Be trusted with real responsibility and ownership
- Competitive compensation and benefits
- Paid time off
- Health & vision insurance
- Monday–Friday, day shift only
- No weekends
- Strong growth potential as the practice expands
We recognize that professionals with this level of experience are not common. If you're looking for a long-term opportunity where your expertise is valued and your contributions truly matter, we'd love to hear from you.
APPLICATION PROCESS (IMPORTANT)
We are intentionally selective.
If you apply, you will receive instructions to complete a brief assessment.
Completion of the assessment is required before interviews are scheduled.
This helps us ensure alignment in strengths, communication style, and role fit.
Pay: $65,000.00 - $82,000.00 per year
Benefits:
- Health insurance
- Paid time off
Application Question(s):
- What is your favorite thing about your life right now?
- What is most important to you in a job?
- Do you have experience reviewing clinical documentation for claims, medical necessity criteria?
- Tell me what a GAP waiver is?
- Do you have experience contacting medical offices for clinical records?
- Do you have experience with DME billing?
- What is your biggest asset when it comes to any part of revenue cycle management?
Work Location: In person
