Revenue Cycle Manager, Billing, AR & Systems (ABA Healthcare)

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Revenue Cycle ManagerHealthcare Non-Clinical

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Quick Summary

Overview

Location: Remote (India)Job Type: Full-Time | Independent ContractorWork Schedule: Monday–Friday | U.S.

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Revenue Cycle ManagerHealthcare Non-Clinical

Fiesta Health is a rapidly growing ABA provider serving children with autism throughout Georgia. As we continue to expand, we are seeking an experienced Revenue Cycle Manager to oversee all aspects of billing, claim submission, payment posting, denials and appeals, accounts receivable, and revenue cycle systems.

This is not an entry-level billing position. We are looking for someone with extensive experience managing the full revenue cycle for ABA or behavioral health organizations with Medicaid and commercial insurance companies in the United States.

The ideal candidate is fluent in ABA CPT codes and payer-specific billing rules, has personally worked denials and appeals through to overturned decisions, and is comfortable communicating directly with insurance companies to make sure every claim is paid accurately and on time.

The Revenue Cycle Manager is responsible for managing the complete revenue cycle, from the moment a session is documented through final payment and account resolution.

This includes:

Coding and charge review
Pre-billing claim review
Claim submission
Clearinghouse management
Payment posting
Cash reconciliation
Denials management and appeals
Accounts receivable follow-up
Underpayment review
Patient statements and family billing support
Revenue cycle reporting
Practice management system migration

This role requires someone who is proactive, persistent, highly organized, accurate with financial data, and comfortable spending a significant portion of the day communicating directly with insurance companies.

Responsibilities

~1 min read

Assign and verify CPT codes, modifiers, place-of-service codes, and units for all ABA services.
Validate ICD-10 diagnosis codes against documentation and payer requirements.
Review session notes against billed codes and units before claims are submitted.
Apply payer-specific coding and billing rules.
Maintain a payer-specific coding reference.

Make sure every claim has active coverage, a valid authorization, available units, and a signed session note before it is submitted.
Submit clean claims electronically within two business days.
Manage the clearinghouse account, including payer enrollments and user access.
Work clearinghouse rejections and payer edits daily.
Submit secondary, tertiary, and crossover claims.
Track timely filing and appeal deadlines.

Post electronic remittances, checks, and patient payments within one business day.
Reconcile posted payments to bank deposits daily.
Post contractual adjustments, denials, and write-offs with documented reason codes.
Manage credit balances, refund requests, and payer recoupments.
Complete a documented month-end close.

Work every denial within five business days of posting.
Prepare and submit appeals with supporting clinical documentation.
Resolve coordination of benefits and zero-pay claims.
Track appeal outcomes and pursue second-level appeals when needed.
Identify the root cause of denials and report trends.

Own the full accounts receivable portfolio.
Follow up on all unpaid claims over 30 days.
Document every payer contact, reference number, and resolution date.
Escalate payer payment delays.
Reduce balances over 90 days month over month.

Maintain payer fee schedules.
Review paid claims against contracted rates.
Identify and pursue underpayments.
Report rate variances and reimbursement trends.

Generate monthly patient statements.
Respond to family billing inquiries.
Set up and monitor payment plans.
Manage the online patient payment system.

Maintain the revenue cycle dashboard.
Report weekly cash and accounts receivable status.
Track denial rate, clean claim rate, days in A/R, and unbilled sessions.
Identify revenue leakage and recommend process improvements.

Lead the transition to a new practice management system.
Import and validate historical session and claim data.
Set up the clearinghouse and payer electronic enrollments.
Configure fee schedules, payer rules, and claim formats.
Run a parallel billing cycle before cutover.

Requirements

~1 min read

Minimum 5 years of U.S. healthcare revenue cycle experience
Minimum 3 years of ABA or behavioral health billing experience
Extensive experience with:
- ABA CPT codes
- Unit-based billing
- Authorization-driven claim rules
- Medicaid managed care plans
Experience billing both Medicaid and commercial insurance companies.
Experience with secondary and tertiary billing, crossover claims, and coordination of benefits.
Experience working denials and appeals through to overturned decisions.
Experience managing a clearinghouse account.
Experience posting electronic remittances and reconciling to bank deposits.
Experience managing accounts receivable and reducing aged balances.
Experience completing a month-end revenue close.
Working knowledge of payer contracts and fee schedules.
Excellent spoken and written English.
Strong knowledge of HIPAA.

Laptop or desktop with at least:
- Intel Core i5 (or equivalent)
- 8 GB RAM
- Webcam
Headset for extended phone calls.
Stable high-speed internet with a backup option.
Quiet, private workspace for daily phone calls and handling confidential information.