Director of Revenue Cycle Management

ABOUT FINNI HEALTH Finni Health empowers autism care providers to start, run, and grow their own practices. We democratize autism care by providing access to our insurance network, purpose-built EHR software, HR solutions, and clinical support. We've experienced rapid growth and are backed by top-tier investors like General Catalyst and Y Combinator. We seek smart, driven individuals eager to innovate in a dynamic, fast-paced environment. WHAT YOU WILL BE DOING: As a Director of Revenue Cycle Management, you will play a critical role in optimizing our revenue cycle operations. Your primary responsibilities will include: - A/R Management - Denials - Research root cause of denials, identify trends across payers and clinics, determine best course for revenue recovery, and implement denial prevention workflows and product enhancements - Agings - Identify issues and root causes of aged AR; ensure aged AR is properly prioritized and worked - Held Claims - escalate holds with various stakeholders and keep progression towards a resolution - Claims Management - Scrubbing Logic: Oversee claim processing, ensuring logic adjustments (modifiers, rendering provider updates, contract rate validation) are handled seamlessly without delaying timely filing limits. - Vendor Oversight: Manage, audit, and hold external billing vendors or offshore teams accountable to strict Service Level Agreements (SLAs) and productivity benchmarks. - Team Management - Performance manage a team of claims specialists to ensure denials are properly prioritized in terms of agings and AR amount - Track team productivity and quality - Strategic Leadership & Process Optimization - System Design: Architect, implement, and continuously refine standard operating procedures (SOPs) across all billing, coding, authorization, and cash posting workflows. - A/R Momentum: Drive strategies to consistently maximize net collections, minimize Days in A/R, and aggressively reduce write-offs. - Cross-Functional Collaboration: Partner directly with Clinical Operations, Tech/Product, Compliance, and Finance to ensure clean data flow from initial client intake to final reimbursement. - Compliance and Quality Assurance: - Payer Compliance: Maintain exhaustive, up-to-date knowledge of regional Medicaid modifiers, centralized credentialing nuances, and telehealth billing rules. - Audit Readiness: Keep the organization fully compliant with HIPAA regulations, state-specific prompt pay laws, and independent industry accreditation parameters. - Additional Responsibilities: - Adapt and take on evolving responsibilities and projects as Finni Health grows and the RCM landscape changes. ABOUT YOU: You are a proactive and collaborative individual contributor with a strong background in revenue cycle management, driven by a commitment to operational excellence and financial performance. - Experience: 7+ years of relevant experience in revenue cycle management, RCM operations, or related roles, preferably in an early-stage startup, behavioral or mental health, or healthcare tech. Strong understanding of RCM processes, including billing, claims, collections, denial appeals, and accounts receivable management. - Collaborative & Independent Contribution: Proven ability to work effectively within a team environment, contributing to collective success, and independently driving RCM initiatives. - RCM Expertise: Deep understanding of the full revenue cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance (e.g., CMS billing). - Analytical & Problem-Solving: Strong ability to analyze complex RCM data, identify trends, root causes of issues, and implement effective, data-driven solutions to optimize financial performance. - Process Optimization: Demonstrated expertise in identifying inefficiencies and driving process improvements for RCM efficiency and effectiveness. - Communication & Collaboration: Excellent written and verbal communication skills, with proven ability to effectively collaborate with internal teams and external stakeholders (payers, vendors, providers). - Organizational & Time Management: Exceptional organizational and time management skills, with the ability to manage multiple priorities and projects in a fast-paced environment. - Tech Proficiency: Proficient in Google Suite, Slack, CRM/support software, and EHR/RCM management tools. Experience with various EMR/EHR work queue management within RCM is a plus. - Mission Alignment: Passion for Finni’s mission to democratize autism care and empower providers through robust RCM. - Adaptability & Agility: Comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive mindset. Ready to make a significant impact at a rapidly growing healthcare startup? We'd love to hear from you!