Fiesta Health

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

Remote - Contracted

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.

Apply: Revenue Cycle Manager, Billing, AR & Systems (ABA Healthcare)
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Are you legally able to provide independent contractor services to a United States company from your country of residence in India?*
Do you currently reside in India?*
What city and state do you currently reside in?*
This is a full-time, fully remote independent contractor engagement with fixed hours of Monday–Friday, 8:30 AM–6:00 PM U.S. Eastern Time. In India this is approximately 6:00 PM–3:30 AM or 7:00 PM–4:30 AM IST, depending on U.S. daylight saving time. Can you consistently work this schedule?*
What is your expected monthly compensation for this full-time independent contractor engagement?*
Do you have a reliable laptop or desktop with a webcam, a headset suitable for extended calls, stable high-speed internet with a backup option during outages, and a quiet, private workspace appropriate for handling protected health information and financial records?*
Before any system, payer portal, clearinghouse, or financial report access is granted, this role requires a signed Business Associate Agreement, a confidentiality and non-disclosure agreement, an independent contractor agreement, and a background check appropriate to financial and protected health information access. Are you willing to complete all of these?*
All billing records, claim files, remittance detail, payer correspondence, trackers, reports, and written procedures must be created and kept only in Fiesta Health owned systems, never on personal devices or personal accounts. Do you agree to work under this requirement?*
How many years of United States healthcare revenue cycle experience do you have (coding, claim submission, payment posting, denials, and accounts receivable)?*
How many years of applied behavior analysis (ABA) or behavioral health billing experience do you have, including ABA CPT codes, unit-based billing, and authorization-driven claim rules?*
Have you billed both Medicaid and commercial payers, including Medicaid managed care plans?*
Which of the following revenue cycle functions have you personally performed (not only supervised)?*
Which ABA CPT codes have you billed?*
In your own words, explain the difference between CPT 97153 and 97155, how units are calculated for these codes, and one payer rule you have seen that affects how they can be billed together.*
Have you personally prepared and submitted insurance appeals that resulted in overturned denials, rather than delegating them to someone else?*
Describe a denial you personally worked through to an overturned decision. Include the payer type, denial reason, what documentation you gathered, the appeal level, and the outcome.*
Have you worked secondary and tertiary claims, crossover claims, and coordination of benefits denials, including billing Medicaid as payer of last resort?*
Have you administered a clearinghouse account, including payer enrollments, submitter identifiers, user access, and daily rejection work?*
Have you posted electronic remittance advice and reconciled posted payments to bank deposits on a daily basis?*
Have you completed a documented month-end revenue close reconciling charges, payments, adjustments, and accounts receivable?*
Describe how you have reduced aged accounts receivable, especially balances over 90 days. Include the starting balance or percentage, the actions you took, and the measurable result.*
Have you reviewed paid claims against contracted rates or fee schedules to identify and recover underpayments?*
Have you managed credit balances, refund requests, and payer recoupments, including the federal 60-day report-and-return requirement for Medicare and Medicaid overpayments?*
Which practice management systems, EHR billing modules, clearinghouses, and payer portals have you used? Please list each.*
Have you led or supported a practice management system implementation, data migration, or clearinghouse conversion?*
If yes, describe your role in the implementation or migration, how you validated migrated balances and historical data, and how you confirmed nothing was lost before cutover.*
Have you transitioned revenue cycle functions in-house from an external billing vendor?*
Do you hold a coding or billing credential?*
Do you have billing experience with Georgia Medicaid, the Georgia Medicaid portal, or Georgia Medicaid managed care plans?*
This role requires professional-level spoken and written English to communicate with U.S. insurance companies, families, and internal teams. What is your level of professional English fluency?*
A significant portion of each workday is spent on the phone with U.S. insurance companies. Are you comfortable with extended daily payer calls?*
This role works within defined internal controls: adjustments and write-offs above threshold require prior approval, the role has no authority to initiate bank transactions, issue refunds, or release payments, physical mail and checks are handled by leadership, and adjustments are subject to periodic supervisory review. Do you understand and accept these controls?*
Scenario: A session is ready to bill, the authorization is valid with units available, but the session note is unsigned and the payer’s timely filing deadline is three business days away. Describe exactly what you would do.*
Scenario: Today’s posted payments do not match the bank deposit by $480. Walk through the steps you would take to find and resolve the variance, and by when.*
Scenario: Over two weeks, a payer denies a group of claims for “no authorization on file,” although your records show active authorizations. How would you resolve the claims and prevent it from recurring?*
Please confirm you are comfortable owning daily billing production (submission, posting, reconciliation, and denials) while also completing longer-term analysis and system migration work, without letting either slip.*
What would a successful first 90 days in this role look like from your perspective?*
What interests you about leading the revenue cycle for an ABA organization at Fiesta Health?*
Human Check*