Director/Senior Manager, Revenue Cycle Management
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Job Description
Revenue cycle leader scaling payer contracting, billing, denials, collections, and reconciliation. Supporting Clarity Pediatrics’ virtual pediatric chronic-care platform as it grows.
Responsibilities:
- Own strategy, systems, and execution across payer contracting, billing, denials, collections, and reconciliation
- Lead and develop the RevOps Lead and Associates
- Set priorities, coach on complex cases, and build a scalable team structure
- Negotiate payer rates and terms and manage the contract lifecycle
- Ensure contract terms are accurately loaded and enforced across billing systems
- Own billing strategy, claims submission accuracy, coding integrity, and clean-claim rates
- Track denial trends by payer and reason code
- Lead root-cause analysis spanning credentialing, contracting, and patient eligibility
- Build cross-functional mechanisms with Patient Support, Provider Operations, Growth, and Product teams
- Lead reconciliation of payer remittances (ERA/EOB) and claims-related bank activity against contracted terms
- Oversee collections and A/R management to maintain low aging balances and predictable cash flow
- Support the Head of Finance during month-end close
- Own reconciliation deliverables, A/R and denial reporting, and collections-risk analysis
- Serve as the revenue cycle performance subject-matter expert across operational and finance stakeholders
- Translate billing and denial details into actionable recommendations
- Optimize billing processes and codes
- Implement process, tooling, and documentation improvements for scalable, accurate billing, denials, and reconciliation
- Partner with Product and Engineering on improvements
- Maintain controls for audit readiness and compliance
Requirements:
- 5-7+ years of total revenue cycle experience
- 2-3+ years managing a team in a billing/RCM or similar operations function
- More extensive, progressively responsible experience, including payer contract negotiation, considered for the Director-level title
- Ability to trace claims back to credentialing, contracting, or eligibility and fix root causes
- Experience owning cross-functional outcomes involving contracting, credentialing, and patient access
- Ability to build and maintain trackers and reports monitoring collection rates, denial trends, and A/R aging
- Ability to use data to drive operational fixes
- Ability to clearly explain reconciliation discrepancies to associates and the Head of Finance
- Comfort with ambiguity, evolving processes, and startup environments
- Experience across commercial, Medicaid, and self-pay payer types
- Understanding of differing billing, denial, and collections practices across payer types
Benefits:
- Competitive equity package in an early-stage, well-funded company
- Medical, dental, vision, and ancillary benefits
- 12 therapy appointments per year at no cost to the employee
- Free One Medical membership
- 20% off Kindbody fertility services
- 401(k)
- Flexible PTO
- Full week off for the December holidays
- Remote-friendly work culture
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