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Salary: USD 130,000 - 145,000 / annual
InStride Health is a mission-driven healthtech company delivering specialty anxiety and OCD care for children, teens, and young adults. The company combines research-backed clinical care with innovative technology to expand access to insurance-based mental health treatment, reduce wait times, streamline onboarding, and improve outcomes through evidence-based therapies and outcomes tracking.
You will serve as a strategic senior individual contributor in Revenue Cycle Management (RCM), reporting directly to the Senior Director of RCM. This is a high-impact role focused on identifying and resolving root causes of denials, front-end rejections, and revenue leakage across InStride's RCM operations. Rather than managing people, you will equip the RCM team and leadership with insights, workflows, and system fixes that drive efficiency and accuracy.
Key responsibilities include:
- Analyze end-to-end RCM workflows from pre-billing through denial resolution and patient collections to eliminate bottlenecks and revenue leakage
- Own billing system setup and configuration across RCM platforms (Apero, Sigma, Mahler), including payor billing logic, fee schedules, and contract terms
- Build and maintain RCM KPI dashboards (clean claim rate, denial rate, days in AR, claim lag, appeals, collection rate) and share actionable insights
- Perform routine audits of billing engine rules, logic, and fee schedules for payor compliance
- Lead root-cause analyses on claim denials and underpayments with durable fix recommendations
- Serve as internal checkpoint for claims escalations, ensuring internal options and appeal pathways are exhausted before payor escalation
- Partner with Technology teams on automation for claim submission, denials management, and revenue capture
- Collaborate with Payor Operations on systemic payor issues and escalations to health plans
- Manage clearinghouse and internal configuration rules to resolve pre-claim edits and front-end rejections
- Lead coordination with Licensing & Credentialing, Authorization & Eligibility, Patient Access, and Clinical Operations to reduce intake-driven denials
- Lead change management for new billing tools, software integrations, and workflow changes
- Deliver executive-level RCM insights and financial performance reporting to leadership
The role is fully remote with potential to grow into people leadership as the RCM function scales. You will work closely with cross-functional teams including RCM, Payor Operations, Licensing & Credentialing, Authorization & Eligibility, Clinical Admissions, Clinical Operations, and IT.
REQUIREMENTS:
- 6+ years of progressive healthcare revenue cycle management experience, with at least 3 years in an analytical, optimization, or process improvement capacity
- Bachelor's degree in Healthcare Administration, Finance, Business Analytics, or related field; OR 10+ years in healthcare RCM
- Proven track record using complex data sets to streamline RCM operations, reduce claim denials, and recover lost revenue
- Strong project management background with demonstrated success leading cross-functional tech or process improvement projects
- Exceptional analytical and problem-solving skills with high attention to detail
- Clear written and verbal communication skills; ability to translate complex revenue cycle data into actionable insights for diverse teams
- Highly collaborative mindset with proven ability to build effective relationships across clinical, operational, and technical leadership
- Working knowledge of insurance payor policies, billing guidelines, and claims submission requirements
- Familiarity with CPT and ICD-10 codes and their impact on billing and reimbursement
- Hands-on experience with payor contract analysis, fee schedule audits, and underpayment identification and recovery
- Experience configuring billing platforms; experience with Apero, Sigma, Mahler, or similar RCM software preferred
PREFERRED QUALIFICATIONS:
- Behavioral health or telehealth billing background
- Experience in fast-paced, high-growth, or startup healthcare environments
- Hands-on experience building custom clearinghouse rules and RPA/AI solutions
- Advanced technical mastery in SQL, BI reporting platforms (Looker, Power BI), EHR/PM systems, and clearinghouse rule builders
- Passion for pediatric mental health and expanding access to high-quality care
