Senior Revenue Cycle Lead, Provider Ops (Remote)

Oscar-Health-; Atlanta (GA); Remote; USD 122,000 - 160,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonus

Health benefits

Job summary

Oscar Health seeks a Senior Manager for Revenue Cycle Management in Provider Operations. This role leads strategy across professional billing, coding, and denials to optimize reimbursement and financial performance.

You will partner with clinical, operations, finance, compliance, credentialing, and product teams to drive scalable improvements. The position reports to the Director, Clinical Operations and offers a fully remote work model in the U.S., with potential hybrid options in the future.

Qualifications

• 7+ years of progressive experience in healthcare revenue cycle, professional billing, coding, or related healthcare operations.
• 3+ years of experience leading revenue cycle programs, teams, or functions with accountability for outcomes.
• Advanced knowledge of professional billing and coding, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, payer requirements.
• Experience developing and executing revenue cycle strategies that improve coding accuracy, claims performance, reimbursement, and outcomes.
• Experience with coding and clinical documentation integrity, including provider documentation review and pre-/post-bill processes.
• Experience leading cross-functional initiatives with clinical, operations, finance, compliance, credentialing, and product teams.
• Strong executive communication skills for presenting performance, risks, and opportunities to senior leadership.
• Certified CPC/CCS/CCS-P/CPMA or comparable coding credential.

Responsibilities

• Own the strategy and performance of OMG's revenue cycle function, including professional billing, coding, claims management, denials, eligibility, documentation, and related workflows.
• Serve as the senior subject matter expert for coding and billing, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, and payer requirements.
• Establish and monitor revenue cycle KPIs and controls, using data to improve clean claims, reimbursement, denial rates, and financial performance.
• Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, and education to address documentation gaps.
• Lead denial prevention and resolution strategies, identifying systemic trends and implementing corrective actions.
• Partner with clinical leadership on ICD-10/HCC documentation and coding to improve clinically supported diagnoses.
• Develop strategies to address reimbursement, eligibility, claim edits, denials, and payer requirements across multiple states.
• Collaborate with Clinical Operations, Finance, Compliance, Credentialing, Product/Technology to resolve complex revenue cycle issues.
• Develop scalable revenue cycle policies, workflows, governance, and vendor oversight for a growing, multi-state provider organization.
• Advise OMG leadership on performance and opportunities, guiding complex initiatives from identification to implementation.

Skills

Revenue cycle leadership

Coding & billing expertise

Data analysis

Cross-functional collaboration

Executive communication

Multi-state operations

Tools

CPT coding

ICD-10-CM

HCPCS

Job description

Oscar Health seeks a Senior Manager for Revenue Cycle Management in Provider Operations. This role leads strategy across professional billing, coding, and denials to optimize reimbursement and financial performance.

You will partner with clinical, operations, finance, compliance, credentialing, and product teams to drive scalable improvements. The position reports to the Director, Clinical Operations and offers a fully remote work model in the U.S., with potential hybrid options in the future.