RCM Lead, Reconciliation & Cash Posting

Nourish; New York (NY); Hybrid; USD 90,000 - 140,000; Full time

Job summary

Nourish, the US dietitian‑led metabolic health clinic, seeks a senior RCM Lead, Reconciliation & Cash Posting. You will own cash reconciliation across insurance and patient payments, align Stripe and Candid on total cash posted, and resolve unreconciled items and refunds.

You’ll build SOPs and lead a team of virtual assistants to ensure accurate, timely cash posting. Based in NYC or fully remote, you’ll report to the Director of Collections and shape reconciliation workflows for enterprise and

Qualifications

• 5-7 years of cash posting and reconciliation experience.
• Hands-on RCM cash reconciliation across patient and insurance payments.
• Experience matching ERAs/EOBs and checks to deposits.
• Ability to build new SOPs and manage a team.
• Strong written communication for SOPs and cross-functional teams.

Responsibilities

• Own cash reconciliation end to end across patient and insurance payments.
• Reconcile unreconciled items, ERAs, and refunds with root-cause analysis.
• Size backlog and execute a plan to reduce it.
• Onboard and oversee a team of VAs on reconciliation workflows.
• Build and maintain SOPs for reconciliation activities and workflows.

Skills

Cash posting

Reconciliation

ERA/EOB matching

SOPs & process design

Team leadership

Tools

Stripe

Candid

Payer portals

Job description

Health is the most important thing in life, and the American healthcare system is completely broken - poor outcomes, high cost, bad patient experience. We're building a new system from the ground up.

Our mission is to improve people’s health by making it easy to live a healthy lifestyle.

Nourish is the country's largest dietitian-led metabolic health clinic. We’re an AI-native digital health system matching patients with 10,000+ Registered Dietitians, physicians, medications, lab testing, and AI agents to deliver insurance-covered care across all 50 states. Founded four years ago, we've completed millions of appointments, tripled year-over-year, and partnered with health plans covering 200M+ Americans across 250+ health systems.

In 2026 we raised a $100M Series C , bringing total funding to $215M. The round was led by Menlo Ventures , with participation from Thrive Capital , Index Ventures , J.P. Morgan Growth Equity Partners , Maverick Ventures , Y Combinator , BoxGroup , Atomico , Daybreak , and Operator Partners .

Learn more about our Series C here: Nourish Blog , Bloomberg , Fierce Healthcare , Digital Native , The Pulse Podcast.

This is not a job for everyone. We hold an extremely high bar because we believe talent density is our biggest competitive advantage. We're looking for people who actively choose hard, ambiguous problems, who run toward unglamorous work, give and receive candid feedback, and bring relentless resilience without the ego. Our work is important, but we are not self-important. We do this because we’re solving one of the hardest problems in the world, and the problem matters. If that's you, we disproportionately reward it.

About the Role

As an RCM Lead, Reconciliation & Cash Posting, you will own cash reconciliation at Nourish: ensuring we accurately report how much cash we have received from insurance and patients for services. You will keep Stripe and Candid aligned on total patient cash posted, work through unreconciled checks and ERAs, and oversee refund workflows for payers and patients.

You will build the SOPs and workflows for, and oversee, our team of virtual assistants (VAs) on reconciliation, and partner across MNT, new bets, and enterprise to support reconciliation for each of them. This is a high-ownership role where you will clear our unreconciled cash backlog and then become the Nourish expert for the areas you own.

This person will report into our Director of Collections, Riley Moore .

This role is full-time and open to NYC-based or remote employees.

Key Responsibilities:

• Own cash reconciliation end to end across patient and insurance payments, ensuring Stripe and Candid are aligned on total patient cash posted.
• Reconcile unreconciled checks and ERAs, tracing each item to root cause and closing it out.
• Size and sequence our unreconciled cash backlog, and build and execute a timeline to work it down.
• Onboard, direct, and oversee a team of VAs on reconciliation workflows, including work allocation, quality checks, and feedback.
• Build and maintain SOPs and workflows for VAs to manage unreconciled ERAs and cash.
• Oversee refund workflows for payers and patients, with controls in place to prevent incorrect or duplicate refunds.
• Partner across MNT, new bets, and enterprise to build and run reconciliation workflows for enterprise partners.
• Identify opportunities to optimize team workflows, including automation for reconciliation, and tackle improvements independently where you can.

We’d love to hear from you if:

• You have approximately 5-7 years of experience in cash posting and reconciliation.
• You have hands‑on RCM cash reconciliation experience across both patient and insurance payments, including matching ERAs/EOBs and checks to deposits and working unreconciled items to resolution.
• You are comfortable with high‑volume, process‑driven, detail‑heavy work and hold yourself to a high standard of accuracy.
• You have built new processes or SOPs from scratch, not just followed existing ones.
• You are a professional and empathetic written communicator who can write crisp SOPs and adjust your tone for patients, payers, and internal partners.
• You are scrappy and can break down ambiguous discrepancies across systems and solve them independently.
• You are flexible and adaptable in a fast‑paced start‑up environment with changing priorities, and you are low‑ego and actively seek feedback.
• Bonus: experience managing, training, or directing others' work (ideally VAs or offshore teams), familiarity with Stripe, Candid, or comparable billing platforms and payer portals, startup or health‑tech experience, or experience using automation or tooling to streamline reconciliation work.