Revenue Cycle Claims Specialist
Finni Health (YC W23)
Senior Manager, Revenue Cycle Management
Radicle Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Arizona, California, Utah
Visit company websiteSalary
💰 $95,000 - $135,000 per year
Job Level
Senior
About the role
- Oversee all aspects of the revenue cycle process, including charge capture, claim submission, payment posting, denials management, collections, and reporting
- Collaborate with product, engineering, and customer success teams to ensure SaaS platform functionality aligns with best practices in healthcare revenue cycle management (RCM)
- Manage payer relationships and ensure compliance with federal, state, and payer-specific billing requirements (Medicare, Medicaid, Commercial)
- Implement and maintain policies and procedures that ensure accuracy, efficiency, and regulatory compliance in revenue cycle operations
- Analyze revenue cycle metrics to identify trends, risks, and opportunities for process improvement
- Partner with finance to reconcile revenue data, support audits, and improve forecasting accuracy
- Lead and develop a team of revenue cycle specialists, fostering accountability and continuous learning
- Act as a subject matter expert (SME) on healthcare billing and RCM for internal stakeholders and customers
- Drive automation and workflow optimization within the SaaS platform to improve the customer billing and claims experience
Requirements
- Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (Master’s preferred)
- 5+ years of experience in healthcare revenue cycle management, with at least 2+ years in a leadership role
- Strong preference for experience in Medicaid-funded behavioral health
- Direct experience in Arizona, Utah, and/or California is a plus
- Familiarity with SaaS or healthcare technology platforms strongly preferred
- Strong knowledge of payer requirements, reimbursement methodologies, coding, billing, and compliance (HIPAA, CMS, etc.)
- Proven track record of reducing denials, improving collections, and streamlining RCM processes
- Exceptional analytical and problem-solving skills; ability to use data to inform decisions
- Excellent communication, leadership, and cross-functional collaboration skills
- Experience with EHRs, billing systems, or healthcare SaaS platforms
