Revenue Cycle & Claims Operations Manager

Jukebox Health is seeking a hands-on Manager of Revenue Cycle & Claims Operations to build and own our end-to-end claims and billing function.

This person will be responsible for converting completed services and program requirements into accurate, timely claims; managing claim submission, rejections, denials, payer follow-up, payment posting, and reconciliation; and improving the internal processes and systems that support clean claims and predictable collections.

The ideal candidate is both a strong revenue-cycle operator and a process builder. This is not a role for someone who expects to inherit a mature EHR, established billing team, and fully standardized workflows. The successful candidate will be comfortable working across Finance, Operations, Partner Success, clinical teams, and external payers to obtain missing information, resolve issues, and own the outcome from claim readiness through cash collection.

• Own end-to-end claims and revenue-cycle operations, including claim readiness, submission, rejections, denials, appeals, payer follow-up, payment posting, reconciliation, aging, and collections reporting across Medicaid managed-care, commercial, and other payer programs.
• Build and optimize payer- and program-specific billing workflows, including claim configuration, test claims, provider and rendering setup, coding/modifier requirements, credentialing and linkage readiness, and scalable processes across internal systems, clearinghouses, and payer portals.
• Drive cross-functional execution and accountability by partnering with Operations, Partner Success, Clinical, Product, Data, and Finance to resolve missing data, improve handoffs, eliminate recurring workflow issues, and build a scalable RCM function capable of supporting more than $1M in monthly claims.

Required

• 7+ years of experience in medical billing, claims operations, or revenue-cycle management
• 3+ years of experience owning or leading a meaningful portion of a revenue-cycle function
• Strong hands-on experience with claim submission, rejections, denials, appeals, payer follow-up, payment posting, and A/R management
• Experience working with Medicaid managed-care plans and complex payer requirements
• Demonstrated ability to configure and launch new payer or program billing workflows
• Experience with billing and rendering-provider structures, NPIs, modifiers, diagnosis codes, procedure codes, authorizations, and timely-filing requirements
• Ability to work effectively without a single fully integrated EHR or mature claims infrastructure
• Strong analytical, organizational, and project-management skills
• Ability to work cross-functionally and hold internal and external stakeholders accountable
• Comfort operating both strategically and tactically in a fast-growing environment
• Strong ownership mindset and focus on measurable collection outcomes

Preferred

• Experience in occupational therapy, home health, behavioral health, HCBS, value-based care, or other nontraditional provider models
• Experience with provider credentialing, payer enrollment, CAQH, roster management, and provider linkage
• Experience bringing revenue-cycle operations in-house or transitioning between billing vendors
• Experience implementing or optimizing claims-management, practice-management, clearinghouse, or RCM technology
• Familiarity with Salesforce, Waystar, Availity, PaySpan, or similar systems
• Experience working in a healthcare startup or rapidly scaling organization
• CPC, CPB, CRCR, or comparable certification is a plus but not required