Revenue Cycle Leader for RTM/CCM/PCM Billing

Alt; United States; Remote; USD 90,000 - 100,000; Full time

Job summary

Flagler Health is seeking a player-coach revenue cycle leader to run care management billing hands-on today while building a scalable function for growth. You will supervise a small team of billers, own collections performance across partner practices, and serve as the go-to expert for RTM, CCM, and PCM coding, billing, and payment.

You’ll focus on reconciliations, denial resolution, and ensuring accurate claim entry across multiple EHR and practice management systems, while shaping processes

Qualifications

• 5+ years of hands-on revenue cycle experience in physician practice or ambulatory billing, including A/R follow-up, denial management, and payment reconciliation
• 2+ years leading or supervising billers, coders, or a denials team
• Working knowledge of CPT and ICD-10-CM coding guidelines, ideally for care management codes (RTM, CCM, PCM)
• Experience with Medicare, Medicare Advantage, and commercial payers, including working directly with payer representatives
• Experience across multiple EHR and practice management systems
• Strong spreadsheet skills (pivot tables, lookups) for claim-level analysis
• Clear written communication; comfortable writing SOPs and presenting findings to clients and leadership

Responsibilities

• Owns charge and payment reconciliation. Reconciles billed services against posted charges, payments, and adjustments for every new partner practice, establishing the clean baseline that all collections analysis depends on.
• Runs monthly claim-level payment analysis. Pulls charge, payment, and adjustment reports from partner practice management systems, breaks them down by date of service, payer, program, and CPT code, and flags claims that are unpaid, underpaid, denied, or adjusted off in error. Sets the thresholds that trigger a full account review and owns each flagged account through resolution.
• Leads payer follow-up and denial resolution. Researches denial and underpayment patterns, contacts payers directly to find root cause, and recommends corrective action (rebills, appeals, coding or front-end fixes) rather than one-off workarounds.
• Oversees claim entry and corrections. Ensures claims are entered accurately and on time across multiple EHR and practice management systems, including self-pay charges and client-requested claim holds, and corrects errors partner practices send back.

Skills

Revenue cycle

Team leadership

Coding knowledge

Payer relations

Spreadsheet skills

Written communication

Tools

EHR systems

Practice management systems

Job description

Flagler Health is seeking a player-coach revenue cycle leader to run care management billing hands-on today while building a scalable function for growth. You will supervise a small team of billers, own collections performance across partner practices, and serve as the go-to expert for RTM, CCM, and PCM coding, billing, and payment.

You’ll focus on reconciliations, denial resolution, and ensuring accurate claim entry across multiple EHR and practice management systems, while shaping processes