RCM Lead, Reconciliation & Cash Posting

Nourish • New York, NY

6d

About The Position

The RCM Lead, Reconciliation & Cash Posting will own cash reconciliation at Nourish, ensuring accurate reporting of cash received from insurance and patients for services. The role keeps Stripe and Candid aligned on total patient cash posted, resolves unreconciled checks and ERAs, and oversees refund workflows for payers and patients.

The lead will clear the unreconciled cash backlog, create standard operating procedures and workflows, and onboard and oversee virtual assistants responsible for reconciliation work. The role also partners with MNT, new bets, and enterprise teams to support and build reconciliation workflows for their needs. This is a high-ownership role that will become the internal point of expertise for the areas it owns. The position reports to the Director of Collections, Riley Moore, and is open to NYC-based or remote employees.

Requirements

• Approximately 5–7 years of experience in cash posting and reconciliation.
• Hands-on RCM cash reconciliation experience across patient and insurance payments, including matching ERAs/EOBs and checks to deposits and resolving unreconciled items.
• Comfort with high-volume, process-driven, detail-heavy work and a high standard of accuracy.
• Experience building new processes or SOPs from scratch.
• Professional and empathetic written communication skills, including the ability to write clear SOPs and adapt tone for patients, payers, and internal partners.
• Ability to break down ambiguous discrepancies across systems and solve them independently.
• Flexibility and adaptability in a fast-paced startup environment with changing priorities, and a low-ego approach that includes actively seeking feedback.

Nice To Haves

• Experience managing, training, or directing others' work, ideally virtual assistants or offshore teams.
• Familiarity with Stripe, Candid, comparable billing platforms, or payer portals.
• Startup or health-tech experience.
• Experience using automation or tooling to streamline reconciliation work.

Responsibilities

• Own end-to-end cash reconciliation across patient and insurance payments, ensuring Stripe and Candid are aligned on total patient cash posted.
• Reconcile unreconciled checks and ERAs by tracing items to their root causes and resolving them.
• Size and sequence the unreconciled cash backlog and build and execute a timeline to reduce it.
• Onboard, direct, and oversee virtual assistants on reconciliation workflows, including work allocation, quality checks, and feedback.
• Build and maintain SOPs and workflows for virtual assistants managing unreconciled ERAs and cash.
• Oversee payer and patient refund workflows, with controls to prevent incorrect or duplicate refunds.
• Partner across MNT, new bets, and enterprise to build and operate reconciliation workflows for enterprise partners.
• Identify opportunities to optimize team workflows, including reconciliation automation, and independently implement improvements where possible.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed