Finance & Billing Operations Manager

Remote Finance and Billing Operations support for California and Washington operations, with a role focused on improving billing performance, revenue-cycle accountability, and financial visibility. This position offers 401(k) matching plus health insurance and life insurance.

The Finance & Billing Operations Manager owns financial operations and cash-flow forecasting while building reporting that executive leadership can rely on. You will set clear billing expectations, strengthen accounts receivable follow-up, and help leadership make informed decisions around spending, hiring, and program growth.

Responsibilities

• Own billing operations across healthcare programs, ensuring productivity, accuracy, timeliness, and follow-through of billing staff.
• Define billing deadlines and performance expectations; monitor services delivered versus services actually billed.
• Identify earned revenue that has not been billed and claims or invoices submitted but not yet paid.
• Track rejected, denied, delayed, or underpaid claims, and ensure appropriate follow-up, correction, and resubmission.
• Monitor authorization-related billing issues and build systems to track outstanding billing issues from identification through resolution.
• Partner with operations leadership to address documentation or workflow problems affecting reimbursement.
• Develop billing dashboards and provide weekly reporting; maintain accurate accounts receivable reporting including balances and aging.
• Establish follow-up procedures for unpaid receivables, identify collection bottlenecks, assign responsibility for outstanding items, and ensure follow-through.
• Reconcile expected revenue against actual collections and track collection trends to identify recurring payment issues.
• Improve the speed from service delivery to cash collection and develop a rolling 13-week cash-flow forecast, updating projections with actual collections and expenses.
• Separate confirmed cash from projected or uncertain revenue; forecast payroll and major operating expenses and identify potential cash-flow shortages early.
• Create conservative, expected, and growth cash-flow scenarios when appropriate and make recommendations to leadership regarding spending, hiring, and financial commitments.
• Prepare regular executive-level financial reports covering cash position, cash-flow forecast, revenue, collections, A/R aging, outstanding billing, billing productivity, denials and rejections, payroll, major expenses, budget versus actual, program-level performance, revenue trends, and financial risks.
• Proactively surface key trends and bring both issues and proposed solutions to leadership; investigate significant budget variances.
• Develop and maintain organizational and program budgets, revenue and expense forecasts, and support financial modeling for hiring, expansion, contracts, and new programs.
• Build internal financial processes and controls, including approval and documentation workflows; support expense management and accounts payable oversight.
• Review payroll reports for unusual trends or discrepancies; coordinate with external accounting, tax, and payroll resources as needed.
• Ensure financial records and supporting documentation are organized and available; review financial reports for accuracy and completeness and ensure reconciliations are completed timely.
• Identify gaps between internal finance operations and external accounting services, recommend what should remain outsourced versus managed internally, and coach billing and finance staff.
• Set expectations, assign responsibility, establish deadlines, monitor performance, follow up on incomplete work, and develop corrective action plans with leadership/HR when necessary.
• Build measurable KPIs for billing and finance staff.

Requirements

• 5+ years of progressive experience in finance, accounting, billing, revenue cycle, financial operations, or a related field.
• Demonstrated experience managing financial operations.
• Experience managing or supervising billing, finance, accounting, or revenue-cycle staff.
• Strong accounts receivable and collections experience.
• Experience with budgeting and cash-flow forecasting.
• Strong Excel and/or Google Sheets skills.
• Ability to analyze financial information and explain it clearly to non-financial executives.
• Experience developing financial reports and dashboards.
• Strong attention to detail, organizational, and project-management skills.
• Ability to work independently in a remote environment.
• Proven ability to create systems and improve processes, not just maintain them.

Technologies

• Excel
• Google Sheets
• Gusto
• QuickBooks

Strongly Preferred

• Experience in healthcare, Medicaid, managed care, behavioral health, social services, community-based services, or another reimbursement-driven environment.
• Healthcare billing or revenue-cycle experience.
• Experience managing billing across multiple programs or contracts.
• Experience working with multi-state organizations.
• Experience with Gusto.
• Experience with QuickBooks or comparable accounting systems.
• Experience working with external accounting or CPA firms.
• Experience building financial operations for a growing organization.

Application Question

Along with your application, please answer: You join a growing organization with operations in multiple states. Leadership believes there may be unbilled revenue, accounts receivable needs stronger follow-up, and cash-flow forecasting needs improvement. You are given responsibility for Finance and Billing. What would you assess and accomplish during your first 30 days?

Location: Kentucky (remote)
Salary: USD 60,194 - 72,492 per year