Fiesta Health · 1 month ago
Billing & Revenue Cycle Specialist
United States
Part-time
Remote
Mid Level
$22/hr - $22/hrFiesta Health is a healthcare organization focused on maintaining revenue integrity and accurate billing processes. The Billing & Revenue Cycle Specialist is responsible for managing billing workflows, ensuring compliance, and supporting insurance audits while collaborating with the team to enhance operational efficiency.
ChildrenHealth CareMedicalTherapeutics
Responsibilities
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
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
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
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
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
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
Qualification
Required
Experience in billing and revenue cycle management
Strong attention to detail and accuracy in data entry
Ability to manage multiple tasks and prioritize effectively
Excellent communication skills, both verbal and written
Proficiency in using billing software and databases
Knowledge of insurance authorizations and claims processing
Ability to work independently and as part of a team
Experience with audits and compliance in a healthcare setting
Familiarity with Coordination of Benefits (COB) processes
Strong organizational skills and ability to meet deadlines
Company
Fiesta Health
Fiesta Health offers ABA therapy for children with Autism and career opportunities for BCBAs and RBTs.
11-50 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase