Billing & AR Resolution Lead

About the Role

Tia is looking for a Billing & AR Resolution Lead to take ownership of our claims follow-up, denials, and payer rejection functions. This is a hands-on role where you’ll work claims, resolve denials, and push aging accounts receivable (AR) to resolution every day. You’ll partner closely with the Senior Manager of Revenue Cycle Management (RCM) as a true right hand on a lean team.

Take full ownership of AR follow-up, flag payer trends before they turn into revenue problems, and bring good ideas for how the function should grow. If you see a messy queue and want to fix the system behind it—not just clear the backlog—this role is for you.

What You’ll Do

AR Follow-Up, Denials & Payer Rejections

• Own day-to-day AR follow-up across commercial payers, resolving denials and payer rejections from root-cause identification through resubmission.

• Work claims across multiple queues and payer rule sets, prioritizing by dollar impact, aging, and likelihood of recovery.

• Partner with Tia’s external billing partner on complex appeals and escalated claim issues, providing documentation and context for resolution.

• Track denial reasons and outcomes closely to identify systemic issues (eligibility, contract terms, coding, payer behavior changes) before they compound.

• Bring data and recommendations to RCM leadership on AR risks and opportunities, not just status updates.

Workflow & Process Design

• Build and document SOPs, queue structures, and escalation paths to turn AR follow-up into a repeatable process.

• Spot friction points in the claims-to-cash workflow and design fixes, not just flag problems.

• Create reference materials and training documentation for new team members.

Cross-Functional Support

• Serve as the subject matter expert on RCM-related questions for Tia’s Billing Care Coordinators.

• Take ownership of escalations requiring claim edits, payer-specific fixes, or RCM-level intervention.

What You’ll Bring

Requirements:

• 3+ years of hands-on experience in medical billing, AR follow-up, denials management, and payer rejections in a healthcare setting.

• Deep working knowledge of commercial payer rules and claim adjudication.

• A track record of improving workflows, building SOPs, and fixing root causes.

• Comfortable working independently in a lean, fast-moving team.

• Sharp pattern recognition to identify issues before they escalate.

• Strong written communication for internal documentation, payer correspondence, and cross-functional collaboration.

• Experience with billing platforms such as Candid, Athenahealth, Epic, or similar RCM/EHR systems.

• Multi-state/multi-market billing experience.

Nice to Have:

• Experience building or improving RCM workflows, documentation, or training materials.
• Exposure to women’s health and telehealth.
• A demonstrated interest in growing into broader ownership as Tia’s RCM function scales.
• Certification such as CPB, CPC, or CRCR.