Remote Jobs RockRemote Jobs Rock

Revenue Cycle Manager & Subject Matter Expert, Care Management Billing

๐Ÿ•’ 2 days ago
Revenue Cycle ManagementAmbulatory BillingA/R Follow-upDenial Management
Apply Now

๐Ÿ“œ Description

  • Own charge and payment reconciliation and monthly claim-level payment analysis across partner practices.
  • Lead payer follow-up and denial resolution, and oversee accurate, timely claim entry and corrections.
  • Manage and coach billers and contractors; set priorities, track productivity, and audit work quality.
  • Review coding compliance, maintain coding guides, and document billing workflows and SOPs.
  • Lead billing implementation and serve as the billing escalation point for partner practices.
  • Improve billing processes and partner with engineering on automation for reconciliation, denial triage, and collections follow-up.

๐Ÿ› ๏ธ Requirements

  • 5+ years of hands-on revenue cycle experience in physician practice or ambulatory billing, including A/R follow-up, denial management, and payment reconciliation
  • 2+ years leading or supervising billers, coders, or a denials team
  • Working knowledge of CPT and ICD-10-CM coding guidelines, ideally for care management codes (RTM, CCM, PCM)
  • Experience with Medicare, Medicare Advantage, and commercial payers, including working directly with payer representatives
  • Experience across multiple EHR and practice management systems
  • Strong spreadsheet skills (pivot tables, lookups) for claim-level analysis
  • Clear written communication; comfortable writing SOPs and presenting findings to clients and leadership
Full job description

Flagler Health is building the clinical operating system for modern musculoskeletal care.

We partner with MSK provider groups and specialty clinics to help them grow, operate more efficiently, and deliver better longitudinal care across patient acquisition, clinical workflows, and ongoing patient engagement. Our platform sits at the intersection of care delivery and clinic operations, helping providers capture more value across the full patient lifecycle.

Weโ€™ve recently raised our Series B and are entering our next phase of growth.

About the role

This is a player-coach role for a revenue cycle leader who will run care management billing hands-on today while building a function that scales with the business. You will lead a small team of billers, own collections performance across a growing set of partner practices, and serve as the go-to expert on how remote therapeutic monitoring (RTM), chronic care management (CCM), and principal care management (PCM) services are coded, billed, and paid.

Billing operations and collections

  • Owns charge and payment reconciliation. Reconciles billed services against posted charges, payments, and adjustments for every new partner practice, establishing the clean baseline that all collections analysis depends on.

  • Runs monthly claim-level payment analysis. Pulls charge, payment, and adjustment reports from partner practice management systems, breaks them down by date of service, payer, program, and CPT code, and flags claims that are unpaid, underpaid, denied, or adjusted off in error. Sets the thresholds that trigger a full account review and owns each flagged account through resolution.

  • Leads payer follow-up and denial resolution. Researches denial and underpayment patterns, contacts payers directly to find root cause, and recommends corrective action (rebills, appeals, coding or front-end fixes) rather than one-off workarounds.

  • Oversees claim entry and corrections. Ensures claims are entered accurately and on time across multiple EHR and practice management systems, including self-pay charges and client-requested claim holds, and corrects errors partner practices send back.

Team leadership

  • Manages a team of billers and contractors. Assigns claim entry, account reviews, and denial work across the team, sets priorities, and tracks throughput against deadlines.

  • Runs the team's operating cadence. Holds regular denials and billing team meetings to resolve open questions, align on coding rules, and standardize how work is documented; holds recurring one-on-ones with each team member.

  • Measures and audits quality. Produces monthly productivity reporting, runs sample-based audits of claim entry and account reviews, and coaches to close gaps.

Coding compliance and documentation

  • Reviews claims for coding compliance. Runs cross-practice reviews against ICD-10-CM guidelines (for example, excludes code pairs and diagnosis sequencing) and CPT rules for care management services, and presents findings to the team and leadership.

  • Builds coding reference materials. Creates and maintains diagnosis pairing guides and program-specific coding tip sheets that billers and clinical staff use day to day.

  • Writes and maintains SOPs. Documents claim entry and billing workflows for each practice management system the team works in, validates them with the people doing the work, and keeps them current as payer and client requirements change.

Client billing support

  • Leads billing implementation for new partner practices. Walks new partners through how RTM, CCM, and PCM billing works, how to configure EHR templates for documentation compliance, and how billing data should flow, and confirms who owns claim entry at each site before go-live.

  • Serves as the billing escalation point for active practices. Holds standing billing and collections calls with a subset of accounts, answers billing questions routed through customer success, and resolves issues across the rest of the book.

  • Routes feedback upstream. Shares denial and underpayment patterns with clinical operations and customer success so recurring issues are fixed at the source instead of reworked downstream.

Process improvement and automation

  • Redesigns processes. Proposes and implements changes that simplify billing workflows, improve accuracy, and shorten time to collection.

  • Partners with engineering. Hands off coding and billing rules as clear requirements, tests the resulting tools, and applies automation to reconciliation, denial triage, and collections follow-up.

  • Strengthens front-end eligibility. Shares data and best practices to improve eligibility checks, benefits verification, and patient enrollment logic so fewer claims fail downstream.

What you bring

  • 5+ years of hands-on revenue cycle experience in physician practice or ambulatory billing, including A/R follow-up, denial management, and payment reconciliation

  • 2+ years leading or supervising billers, coders, or a denials team

  • Working knowledge of CPT and ICD-10-CM coding guidelines, ideally for care management codes (RTM, CCM, PCM)

  • Experience with Medicare, Medicare Advantage, and commercial payers, including working directly with payer representatives

  • Experience across multiple EHR and practice management systems

  • Strong spreadsheet skills (pivot tables, lookups) for claim-level analysis

  • Clear written communication; comfortable writing SOPs and presenting findings to clients and leadership

Nice to have: CPC, CPB, or CRCR certification; experience working with engineering teams on billing automation; experience at a growth-stage healthcare services company.

Compensation: $90,000โ€“$100,000 annually, negotiable based on experience and qualifications, with an opportunity for compensation review after six months.

Our Values:

This is what you can expect of your teammates at Flagler:

  • Owner: We own our work like founders. We don't wait to be asked, and we pick up the problem nobody else has.

  • Builder: We like making things from scratch. We don't need a playbook to start, and we'd rather ship a rough first version than wait on a perfect spec.

  • Fast: We make quick decisions. We favor progress and respect process.

  • Transparent: We communicate directly. We value merit and honesty, and we challenge assumptions, including our own.

  • Curious: We explore new approaches and ask "why" often.

Sword

RCM Associate, Member AR & Pre-Access (Contractor)

๐Ÿ•’ yesterday
Sword๐Ÿ‘ฅ 1001 - 5000 employees๐Ÿข Hospital & Health Care

Handle member accounts receivable and pre-access billing by resolving authorization, eligibility, and claims issues, verifying coverage, answering billing questions, and improving revenue cycle workflows.

Revenue Cycle ManagementMedical Billing ClaimsFinancial ClearanceInsurance Verification
Raintree-Systems

Payment Reconciliation Specialist (Physical Therapy/Medical Payments/EHR)

๐Ÿ•’ 6 days ago
Raintree-Systems๐Ÿข Healthcare Technology๐Ÿค B2B

Reconcile bank and billing-system deposits, post payments and remittances, resolve unidentified payments and posting errors, and support accurate month-end close while maintaining timely, compliant payment workflows.

Payment ReconciliationMedical Insurance Payment PostingMedical BillingA/R Follow-up
Pacific Health Group

Clubhouse Billing Analyst

๐Ÿ•’ 17 days ago
Pacific Health Group๐Ÿข Healthcare

Own the end-to-end revenue cycle for Clubhouse Services, preparing compliant bundled-rate claims, verifying eligibility, resolving denials, reconciling payments, and supporting billing workflows and audit readiness.

๐Ÿ“ ๐Ÿ‡บ๐Ÿ‡ธ State-Wide - Remote๐Ÿ’ฐ $24 - $26 / hour๐Ÿ’ผ Full-Time๐ŸŽน Mid-level๐Ÿ’ฌ Billing Specialist๐Ÿ“ข ๐Ÿ‡ฌ๐Ÿ‡ง English Required๐Ÿ“ข ๐Ÿ‡ช๐Ÿ‡ธ Spanish Required
Medical BillingBehavioral Health BillingMedi-cal Eligibility VerificationSMHS Billing
Pacific Health Group

Billing Analyst - Remote CALIFORNIA

๐Ÿ•’ 17 days ago
Pacific Health Group๐Ÿข Healthcare

Manage healthcare revenue-cycle billing from claim preparation and coding through denial resolution, reimbursement reconciliation, and reporting, ensuring accurate, timely, and compliant submissions to Medicaid and other payers.

Medical BillingHealthcare Revenue CycleICD-10CPT
Alper Carreiras

Tรฉcnico de Faturamento II - Benefรญcios Corporativos

๐Ÿ•’ 6 days ago
Alper Carreiras๐Ÿ‘ฅ 1001 - 5000 employees๐Ÿข Insurance

Responsรกvel por executar e conferir rotinas de faturamento e recebimento de benefรญcios corporativos, conciliando dados entre sistemas, aplicando rateios e isenรงรตes e cumprindo prazos e padrรตes de qualidade.

FaturamentoControle De RecebimentosConciliaรงรฃo De DadosRateios

Trusted by Remote Workers