Revenue Cycle Manager & Subject Matter Expert, Care Management Billing

Flagler Health•New York, NY

22d•$90,000 - $100,000

About The Position

Flagler Health is hiring a hands-on revenue cycle leader to manage care management billing while building a function that can scale with the business. The role leads a small team of billers, owns collections performance across partner practices, and serves as the subject matter expert on coding, billing, and payment for remote therapeutic monitoring (RTM), chronic care management (CCM), and principal care management (PCM) services. The manager oversees charge and payment reconciliation, monthly claim-level payment analysis, payer follow-up, denial resolution, and accurate claim entry across multiple EHR and practice management systems. The role also leads team operations and quality audits, supports coding compliance and documentation, develops coding references and SOPs, and guides partner practices through billing implementation and ongoing billing questions. The position identifies process improvements, works with engineering on billing automation, and shares billing trends with clinical operations and customer success to address recurring issues at their source. Compensation is $90,000–$100,000 annually, negotiable based on experience and qualifications, with an opportunity for a compensation review after six months.

Requirements

At least 5 years of hands-on revenue cycle experience in physician practice or ambulatory billing, including A/R follow-up, denial management, and payment reconciliation.
At least 2 years leading or supervising billers, coders, or a denials team.
Working knowledge of CPT and ICD-10-CM coding guidelines; care management codes (RTM, CCM, PCM) are particularly relevant.
Experience with Medicare, Medicare Advantage, and commercial payers, including direct communication with payer representatives.
Experience working across multiple EHR and practice management systems.
Strong spreadsheet skills, including pivot tables and lookups, for claim-level analysis.
Clear written communication skills, with the ability to write SOPs and present findings to clients and leadership.

Nice To Haves

CPC, CPB, or CRCR certification.
Experience working with engineering teams on billing automation.
Experience at a growth-stage healthcare services company.

Responsibilities

Reconcile billed services against posted charges, payments, and adjustments for each new partner practice.
Run monthly claim-level payment analysis by date of service, payer, program, and CPT code, and identify unpaid, underpaid, denied, or incorrectly adjusted claims.
Set thresholds for full account reviews and own flagged accounts through resolution.
Research denial and underpayment patterns, contact payers to identify root causes, and recommend corrective actions such as rebills, appeals, coding fixes, or front-end changes.
Oversee accurate and timely claim entry and corrections across multiple EHR and practice management systems, including self-pay charges and client-requested claim holds.
Assign work to billers and contractors, set priorities, and track throughput against deadlines.
Run regular billing and denials meetings and recurring one-on-ones with team members.
Produce monthly productivity reports, conduct sample-based audits of claim entry and account reviews, and coach team members to address quality gaps.
Review claims for compliance with ICD-10-CM guidelines and CPT rules for care management services, and present findings to the team and leadership.
Create and maintain diagnosis pairing guides and program-specific coding tip sheets.
Write, validate, and maintain SOPs for claim entry and billing workflows across the practice management systems used by the team.
Lead billing implementation for new partner practices, including explaining RTM, CCM, and PCM billing, advising on EHR template configuration for documentation compliance, clarifying billing data flows, and confirming claim-entry ownership before go-live.
Serve as the billing escalation point for active practices, hold standing billing and collections calls with assigned accounts, answer questions routed through customer success, and resolve issues across the practice portfolio.
Share denial and underpayment patterns with clinical operations and customer success to address recurring issues at their source.
Propose and implement process changes to simplify billing workflows, improve accuracy, and shorten time to collection.
Translate coding and billing rules into clear engineering requirements, test resulting tools, and apply automation to reconciliation, denial triage, and collections follow-up.
Share data and best practices to strengthen eligibility checks, benefits verification, and patient enrollment logic.