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

Location

Remote (India)

Job Type

Full-Time | Independent Contractor

Work Schedule

Monday–Friday | U.S. Business Hours

About Fiesta Health

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.

Position Overview

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.

Key Responsibilities

Coding & Charge Review

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.

Claim Submission & Clearinghouse Management

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.

Payment Posting & Reconciliation

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.

Denials Management & Appeals

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.

Accounts Receivable Management

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.

Underpayment & Contract Compliance

Maintain payer fee schedules.

Review paid claims against contracted rates.

Identify and pursue underpayments.

Report rate variances and reimbursement trends.

Patient Balances

Generate monthly patient statements.

Respond to family billing inquiries.

Set up and monitor payment plans.

Manage the online patient payment system.

Reporting

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.

System Migration

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.

Required Qualifications

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.

Preferred Experience

Experience billing with

Georgia Medicaid (GAMMIS)

Georgia Medicaid managed care plans

ABA organizations

Multi-state provider groups

Multi-location clinics

Experience with

Practice management system implementation or data migration

Clearinghouse conversion

Moving revenue cycle functions in-house from an external billing vendor

Certified Professional Coder (CPC) or equivalent credential

Reimbursement rate benchmarking or contract analysis

Experience using

Practice management or EHR billing systems

Clearinghouse platforms

Payer portals

Microsoft Excel (pivot tables and reconciliation)

Google Sheets

Monday.com (prefe