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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 (preferred)
Required Skills
Outstanding verbal and written communication.
Strong phone etiquette.
Ability to confidently communicate with payer representatives.
Exceptional accuracy and attention to detail.
Strong follow-up skills.
Highly organized.
Analytical mindset.
Excellent time management.
Problem-solving mindset.
Ability to balance daily billing work with longer-term projects.
Technical Requirements
Laptop or desktop with at least:
Intel Core i5 (or equivalent)
8 GB RAM
Webcam
Headset for extended phone calls.
Stable high-speed internet with a backup option.
Quiet, private workspace for daily phone calls and handling confidential information.
Compensation
Competitive (based on experience).
Remote.
Independent Contractor.
At Fiesta Health , we believe that a diverse, inclusive, and equitable workplace is essential to our mission of delivering compassionate, high-quality care. We are proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other legally protected characteristic.
We are committed to building a team that represents a variety of backgrounds, perspectives, and skills—because the more inclusive we are, the better we can serve our community.
