Reports to: CEO
Location: Remote (based in Georgia, USA; occasional travel required)
Position Type: Part-Time
Pay: $22/hour

Position Overview

The Billing & Revenue Cycle Specialist supports Fiesta Health’s team by ensuring accurate billing, managing authorizations for ongoing services, and maintaining revenue integrity through daily insurance checks, COB management, and audit readiness. This role owns backend billing workflows and ensures claims, payments, and authorizations remain compliant and up to date.

Key Responsibilities

Billing & Revenue Cycle Management (RCM)

• Track and log “Ready to Bill” approvals across all business units daily.
• Enter, review, and audit billing data in the system to ensure accuracy.
• Submit claims, monitor denials, and escalate billing issues to leadership.
• Prepare utilization and billing reports for internal audits.
• Support and lead insurance audits, documentation requests, and updates.
• Maintain liability and insurance documentation for all payors.

Ongoing Service Authorizations

• Manage reassessment authorizations and renewals for ABA services.
• Submit and track authorizations for ongoing treatment plans.
• Monitor expiration dates to avoid service disruptions.
• Follow up with clinicians to ensure assessment documentation is submitted on time.

Daily Eligibility Checks

• Complete daily coverage and eligibility checks for existing clients.
• Update internal systems with changes in eligibility or coverage.
• Communicate any discrepancies or lapses to leadership immediately.

Coordination of Benefits (COB)

• Identify and resolve COB issues that impact claim processing.
• Communicate required updates to families and document follow-up.
• Work with payors to ensure accurate primary/secondary insurance designation.

Operations & Systems Support

• Review database entries for accuracy and SOP compliance.
• Maintain up-to-date SOPs for billing, authorizations, and insurance workflows.
• Assist with accounts payable and financial reporting as needed.
• Support credentialing workflows for clinical staff.
   

Team Collaboration

• Lead weekly billing meetings and team calls by facilitating discussion, maintaining structure, ensuring accountability, and keeping the team aligned on priorities. This includes preparing agendas, auditing billing data ahead of each meeting, identifying issues or trends, and driving action items to completion as billing volume scales.
• Join leadership meetings as needed for RCM updates.
• Provide clear communication and follow-up on billing and insurance-related tasks.

At Fiesta Health, we believe that a diverse, inclusive, and equitable workplace is essential to our mission of delivering compassionate, high-quality care. We are proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other legally protected characteristic.

We are committed to building a team that represents a variety of backgrounds, perspectives, and skills—because the more inclusive we are, the better we can serve our community.