Revenue Cycle Manager – Care Management Billing

🔥 14 hours ago

🌐 United States, Canada – Remote

🇺🇸 United States – Remote 🇨🇦 Canada – Remote

💵 $90k - $100k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 20%

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Flagler Health

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2023

🏥 Healthcare

🤖 Artificial Intelligence

⚕️ Healthcare Insurance

Healthcare • Artificial Intelligence • Healthcare Insurance

Flagler Health is an innovative health technology company that empowers healthcare providers by leveraging artificial intelligence to enhance clinical and back-office operations. Their AI solutions, such as the AI Triaging Engine, streamline patient care processes, improve patient outcomes, and ensure efficient scheduling. Flagler Health focuses on optimizing the healthcare experience through data-driven insights, chronic care management, and remote monitoring, ultimately enabling providers to offer more personalized care to their patients.

📋 Description

• Own charge and payment reconciliation for new partner practices • Run monthly claim-level payment analysis and identify unpaid, underpaid, denied, or incorrectly adjusted claims • Lead payer follow-up and denial resolution, including rebills, appeals, coding fixes, and front-end fixes • Oversee accurate and timely claim entry and corrections across multiple EHR and practice management systems • Manage billers and contractors, assign work, set priorities, and track throughput • Run denials and billing team meetings and recurring one-on-ones • Produce monthly productivity reporting, conduct sample-based quality audits, and coach team members • Review claims for ICD-10-CM and CPT coding compliance • Create and maintain diagnosis pairing guides and program-specific coding tip sheets • Write and maintain SOPs for claim entry and billing workflows • Lead billing implementation for new partner practices using RTM, CCM, and PCM services • Serve as billing escalation point for active practices and participate in billing and collections calls • Share denial and underpayment patterns with clinical operations and customer success • Redesign billing processes to improve accuracy and shorten time to collection • Partner with engineering on billing requirements, tool testing, and automation • Improve eligibility checks, benefits verification, and patient enrollment logic

🎯 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, including pivot tables and lookups, for claim-level analysis • Clear written communication; comfortable writing SOPs and presenting findings to clients and leadership • CPC, CPB, or CRCR certification is nice to have • Experience working with engineering teams on billing automation is nice to have • Experience at a growth-stage healthcare services company is nice to have • Authorization to work in the United States or Canada • No current or future visa requirement to continue working in the United States or Canada

🏖️ Benefits

• Compensation review opportunity after six months • Remote work arrangement • Opportunity to lead and build a scalable billing function