Founding Chief Operating Officer

Chorus Software Solutions; New York (NY); Hybrid; USD 250,000 - 450,000; Full time

Job summary

Finale RCM is seeking a Founding Chief Operating Officer to architect the operational engine from day one, coordinating onshore and offshore delivery teams and shaping culture, systems, and strategy. You will own end-to-end RCM operations, build a customer‑success culture, deploy AI and automation, and establish KPI dashboards that reveal performance, cash flow, and payer trends.

This is a remote/hybrid, full‑time role suited to a hands‑on operator who thrives in ambiguity and partners with a

Qualifications

• 10+ years in healthcare RCM operations with revenue cycle accountability
• Deep ABA billing expertise and compliance
• Established payer relationships with commercial insurers and Medicaid MCOs in autism/behavioral health
• Proven track record building onshore and offshore RCM teams
• Hands-on experience implementing AI agents, automation tools, and RCM platforms
• Data-driven operator with dashboards and analytics directing decisions
• Startup mindset thriving in ambiguity and building from scratch
• Partnership mentality focused on client success

Responsibilities

• Own end-to-end RCM operations including VOB, credentialing, contracting, prior authorization, denial management, appeals, and compliance
• Champion a partnership-first customer success model to drive retention and growth
• Recruit, develop, and lead onshore and offshore teams
• Partner with technology leadership to deploy AI, RPA, and analytics to reduce manual effort and accelerate reimbursement
• Establish operational KPIs, dashboards, and reporting cadences for visibility into performance and payer trends

Skills

Healthcare RCM

ABA billing

Payer relationships

Team leadership

AI & Automation

Data analytics

Executive leadership

Client partnership

Tools

CentralReach

Waystar

Chorus

Passage

Rethink

Job description

Founding Chief Operating Officer | Finale RCM

Autism Care Revenue Cycle Management · Full-Time · Executive Leadership · Remote/Hybrid

About Finale RCM

Finale RCM is a technology-enabled revenue cycle management company built exclusively for the autism care and ABA therapy space. We exist to remove the billing and administrative burden from providers so they can focus on what matters most - delivering life-changing care.

We don't just manage revenue cycles. We partner with ABA providers to protect their mission, powered by technology, data, and a relentless one-team culture.

The Opportunity

We are seeking a Founding COO to join at the ground floor and build the operational engine of our business. This is a rare opportunity to shape culture, systems, and strategy from day one - alongside a founder-led leadership team that moves fast, cares deeply, and plays the long game.

As COO, you will be the operational architect of Finale RCM - translating vision into execution across every function of the business. You'll lead onshore and offshore delivery teams, deploy AI-driven automation, and build a customer success culture that treats every provider like a true partner.

What You'll Own

• End-to-End RCM Operations - Full accountability for VOB, credentialing, contracting, prior authorization, denial management, appeals, and compliance - with ownership of quality, throughput, and client outcomes.
• Customer Success - Champion a partnership-first model where clients experience Finale as an extension of their internal team. Drive retention, satisfaction, and growth through proactive, high-touch engagement.
• Team Building - Recruit, develop, and lead high-performing onshore and offshore teams. Build the management layer that scales with the business while preserving culture and accountability.
• Technology & Automation - Partner with technology leadership to deploy AI agents, RPA, and analytics tools that reduce manual effort, accelerate reimbursement, and surface actionable insights for clients.
• Data & Analytics - Establish operational KPIs, dashboards, and reporting cadences that give clients and internal teams full visibility into performance, cash flow, and payer trends.
• Payer Relations - Build and steward relationships with major commercial payers, Medicaid managed care organizations, and regional plans in the autism/ABA space to improve contracting outcomes and reduce friction.
• Compliance & Risk - Ensure all operations adhere to HIPAA, payer guidelines, and state-specific regulatory requirements, with proactive audit readiness and documented policies.
• Scaling Infrastructure - Design the workflows, SOPs, and technology stack that allow Finale to scale without sacrificing the white-glove service experience.

What You Bring

• 10 years of progressive operations leadership in healthcare RCM with direct accountability for revenue cycle outcomes
• Deep expertise in ABA billing - CPT 97xxx series, payer-specific authorization workflows, and behavioral health compliance
• Established payer relationships and negotiation experience with commercial insurers and Medicaid MCOs in the autism/behavioral health space
• Proven track record building and managing onshore and offshore RCM teams at scale
• Hands-on experience implementing AI agents, automation tools, and RCM platforms (CentralReach, Waystar, Chorus, Passage, Rethink, or similar)
• Data-driven operator comfortable designing dashboards and using analytics to drive decisions and client conversations
• Startup mindset - thrives in ambiguity, builds from scratch, leads by doing
• Partnership mentality - genuinely believes client success is company success

Areas of Mastery

• Verification of Benefits (VOB)
• Prior Authorization
• Provider Credentialing
• Payer Contracting & Negotiation
• Denial Management & Appeals
• Billing Compliance
• Offshore Team Management
• AI Agent Deployment
• RCM Analytics
• Customer Success Strategy
• Workflow Automation
• HIPAA Compliance

Why Finale RCM

• Ground-floor influence - shape the company as a founding member
• Mission-aligned work - serve ABA providers delivering life-changing therapy to children and families
• Category-defining niche - autism care RCM is underserved, fast-growing, and ready for a tech-enabled leader
• One-team culture - clients are partners, offshore colleagues are teammates
• Technology-first foundation - AI and automation are core to our model from day one