Revenue Cycle Manager- School-Based Health Services Billing

Company Overview

Care Solace connects residents, students, and families with mental healthcare and social services in their communities. Our goal is to ensure equitable access to social and mental healthcare services, regardless of income level. Our web-based care navigation system makes it fast, easy, and convenient to connect those in need of social and mental healthcare to qualified providers and resources. Additionally, we offer an All-In-One EHR Built for Schools, designed from the perspective of school staff and the whole child. This platform seamlessly integrates with SIS systems, supports daily workflows, enhances collaboration and documentation of student support, and automates the billing and claims process—empowering schools to focus more on care and less on administrative tasks.

Job Purpose

We are seeking an experienced Revenue Cycle Manager with a focus on school-based billing programs for health services in the state of California. The ideal candidate will have RCM experience with both private and public insurers, a strong understanding of Electronic Health Record (EHR) systems, and thrive in a startup tech environment. You will be responsible for managing the full revenue cycle, including insurance verification, claims review & submissions, and denial management, while ensuring compliance with industry regulations and company policies.

Duties & Responsibilities

Billing & Claims Management:

• Handle the full revenue cycle, including claim submission, and denials & rejections
• Review customer accounts and ensure accurate and timely submission of claims for school-based health services.
• Ensure proper coding (CPT, ICD-10 and billing procedures specific to school-based health services
• Collaborate with customers, third party institutions and other team members to resolve billing inconsistencies and errors
• Updating individual claim details to ensure accurate insurance and student information as needed
• Work cross-functionally with providers, operations, and customer support teams when billing related support is needed

EHR System Expertise:

• Utilize EHR systems for billing purposes, ensuring accurate data entry and account management.
• Troubleshoot EHR issues related to billing workflows and collaborate with the tech team to streamline processes.
• Provide input on EHR system enhancements and assist with testing and implementation of new features related to billing.

Compliance & Reporting:

• Manage internal and external audits as required
• Ensure all billing practices comply with federal and state regulations, including HIPAA, and follow payer guidelines.
• Stay up to date with changes in coding, insurance, and billing regulations in the behavioral & physical health sectors as it relates to school-based programming in California and other states
• Generate billing and revenue reports for leadership review, providing insights and recommendations for process improvements.

Startup Environment Adaptability:

• Operate effectively in a fast-paced, evolving startup environment where flexibility and problem-solving are key.
• Collaborate with cross-functional teams to drive improvements in the RCM process and contribute to the company’s growth.
• Work independently while managing multiple priorities, adapting to new systems and processes quickly.

Qualifications

• 5 years of experience in either medical billing and/or school-based health services billing
• Hands-on experience with EHR systems (e.g., Epic, Kareo, Athenahealth, or similar platforms).
• Strong knowledge of CPT, ICD-10 codes, and insurance claims procedures
• Ability to adapt quickly to changing processes and priorities.
• Excellent communication skills and the ability to work both independently and in a collaborative team environment.
• High attention to detail and strong organizational skills.
• Knowledge of revenue cycle management principles and best practices.

Preferred Qualifications:

• Experience with insurance verification and authorization processes in health services
• Experience in managing school-based billing programs for health services in California
• Familiarity with Medicaid billing
• Sound cross-functional collaboration, ability to strategically prioritize, keep up with a fast-paced entrepreneurial type of environment. You must be able to deal with ambiguity and seek out opportunities to contribute across various teams.
• Proven problem-solving abilities and a proactive approach to identifying and addressing legal risks and issues.

Working Conditions

This position can either work out of the Corporate Office in Cardiff, CA, with 2 remote days per week or work remote full time if out of the San Diego area. Some company events and travel may be required for this position.

Working Hours

Full time.

Physical Requirements

Prolonged periods sitting at a desk and working on a computer.

Must be able to lift up to 15 pounds at times.

Direct Reports

None.

Salary

$85,000 - $95,000 per year. Salary will be dependent on experience.