RCM Customer Success Enabler – Appeals, Coding

Job Title:RCM Customer Success Enabler – Appeals, Coding & Payer Relations (US Healthcare)Location:Remote – Florida preferred / Eastern states Company Overview: Master Billing LLC We are a specialized dermatology billing company dedicated to providing accurate, timely, and patient-friendly billing services. Our team works closely with dermatology practices to ensure smooth revenue cycle operations and exceptional patient support.

Job Summary:We are seeking an experienced & skilled Customer Success Enabler with experience in US Healthcare Revenue Cycle Management (RCM) to support client success through effective appeals management, medical coding accuracy, and strategic payer engagement. This role requires strong expertise in payer contract negotiation, appeals resolution (including Medicare), and coding best practices. Should also bring strong data analysis skills using Microsoft Excel, with macro/VBA knowledge preferred.

The ideal candidate will act as a trusted advisor to clients, driving financial performance, compliance, and long-term satisfaction. Key Responsibilities:Customer Success & Relationship ManagementAct as the primary liaison for our clients, ensuring excellent service delivery and satisfaction. Conduct regular reviews of revenue cycle metrics and provide data-driven recommendations.Resolve client concerns promptly and maintain strong, long-term relationships.

Collaborate with internal teams to tailor RCM strategies to client needs. Appeals & Denial ManagementPrepare and submit appeals for denied claims across multiple payers, including Medicare RAC process. Identify denial trends and implement root-cause mitigation strategies.

Coordinate with billing, coding, and clinical teams to gather documentation and support. Monitor appeal outcomes and ensure timely, compliant submissions. Medical Coding SupportReview claims for accurate coding using ICD-10, CPT, and HCPCS codes.

Work with internal coding specialists and client staff to address documentation issues. Conduct coding audits to ensure compliance with payer and regulatory standards. Provide coding guidance and support during appeals and audits.

Payer Contract ManagementCollaborate with clients and internal stakeholders to review, negotiate, and manage payer contracts. Analyze contract performance, fee schedules, and reimbursement trends. Identify opportunities for improved contract terms and strategic payer partnerships.

Serve as a subject matter expert during contract renegotiations and escalated payer discussions. Process Improvement & EnablementIdentify and implement workflow enhancements to reduce denials and improve collections. Develop SOPs, training materials, and best practices for clients and internal teams.

Leverage RCM and MS Excel to generate KPI reports and client engagement. Support onboarding and training of new clients or staff. Qualifications:4–6 years of experience in US Healthcare Revenue Cycle Management, with a focus on appeals, coding, and payer relations.

Proven experience in payer contract negotiation and management. Strong knowledge of Medicare and commercial payer guidelines and processes. Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential preferred.

Strong proficiency in Microsoft Excel, including data analysis, pivot tables, and formula-based reporting; macro/VBA knowledge preferred. Familiarity with EHR and RCM systems such as Modmed, Advanced MD, EZ Derm, Epic, eClinicalWorks, or Athenahealth. Proficiency in analyzing reimbursement data, denial trends, and contract performance.

Bachelor's degree in healthcare administration, Business, or a related field preferred. Preferred Tools/Skills:Working knowledge of portals (e.g., Availity, Change Healthcare, Trizetto)Provider Enrollments for EDI and ERA Proficiency in Excel and BI tools (e.g., Tableau, Power BI)Knowledge of HIPAA, CMS, and payer-specific regulatory requirements

Success Metrics:Client satisfaction and retention rates

Denial reduction and appeal success metrics

Revenue improvement from contract optimization

Timely resolution of escalated payer issues