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Revenue Cycle Specialist

Revenue Cycle Specialist

One Senior Care, LLC.Pittsburgh, PA, US
17 hours ago
Job type
  • Full-time
Job description

Job Description

Job Description

Bring Your Leadership—Shape Program Integrity for Older Adults

Leverage your healthcare education and hands-on leadership from dynamic health systems to support the Program of All-Inclusive Care for the Elderly (PACE). In this pivotal role, you’ll manage critical Medicare and Medicaid enrollment and revenue operations—directly impacting access to whole-person care for frail older adults.

What You’ll Do :

  • Lead the coordination and oversight of PACE participant enrollments, ensuring adherence to federal and state regulations across Medicare and Medicaid streams.
  • Monitor, audit, and reconcile enrollment data to optimize program compliance and financial integrity.
  • Serve as a subject matter expert and trusted liaison with government agencies, internal cross-functional teams, and care partners.
  • Oversee timely and compliant communications, documentation, and reporting, drawing on your knowledge of policy, process improvement, and healthcare administration.
  • Collaborate on special projects and quality initiatives that strengthen revenue cycle processes and enhance participant outcomes.

What You’ll Bring :

  • Bachelor’s or master’s degree in Health Policy, Healthcare Management, Biobehavioral Health, Business, or related field strongly preferred.
  • 3+ years’ experience in health plan administration, provider network management, or healthcare quality improvement—ideally in PACE, managed care, or health systems.
  • Deep knowledge of healthcare operations, regulatory standards (e.g., NCQA), and data-driven process management.
  • Exceptional organization, systems thinking, and the ability to communicate complex compliance requirements with clarity and precision.
  • Hands-on proficiency in Microsoft Office Suite, participant data systems, and healthcare analytics or CRM platforms (e.g., Salesforce, MedHub, ERAS).
  • Why Join Us?

  • Make a direct impact on the quality of life for older adults and their families.
  • Collaborate with innovative, mission-driven teams across clinical, operational, and finance divisions.
  • Gain leadership visibility in a forward-thinking PACE organization.
  • Requirements :

  • Valid driver’s license, clear record, and successful background / health screening in accordance with PACE standards.
  • Ability to work on-site for cross-team collaboration and occasional event support.
  • If experience includes process improvement, managed care, health plan administration, or multi-department coordination, this specialist position is a prime next step. Empower a healthier, more connected aging community—apply now!

    Benefits :

  • 9 Paid Holidays
  • 3 Weeks and 1 Day of Paid Time Off Accrued from the Date of Hire for Full-Time Employees
  • Medical, Dental, & Vision
  • Free Life and AD&D Insurance Plan
  • Health Savings and Flexible Spending Accounts
  • Short Term Disability Insurance
  • Group Voluntary Term Life Insurance for Employee, Spouses, and Dependents
  • Paid Parental Leave
  • Tuition Reimbursement
  • Retirement Plan with Up to 5K Matching Annually / Vesting Schedule (Pre-taxable Savings)
  • Our organizations provide equal employment opportunities to all employees and applicants for employment. It prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

    The OSC family of businesses will only hire qualified individuals to work in a federally funded healthcare program. Please note that this excludes anyone convicted of a crime that could jeopardize the safety and well-being of the frail senior population that OSC / BP / LIFE-NWPA / MVP serves. All individuals must disclose any conflicts of interest upon applying for a position and agree to a thorough background check when an employment offer is extended.

    Employment Requirements : Successful completion Criminal History Check, Office of Inspector General check, and FBI Fingerprinting for Child Protective Services Law (at employer’s expense). Successful completion of post-offer employment drug screening and physical (at employer’s expense). CPR and First Aid Certification, or willing to obtain at employer’s expense. Individuals must have one year of prior experience caring for the frail elderly or willing to complete Company paid training to meet this requirement.

    This position has full access to Participant, program, and staff records and reports, requiring discretion to protect individuals and the program.

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