Senior Associate, Revenue Operations

Role

We are looking for a seasoned revenue cycle operator who brings deep, hands-on mental and behavioral health billing expertise and is ready to own the revenue cycle end-to-end. This is not a role for someone who needs a well-scoped ticket queue. You will take the lead on moderately complex, loosely-defined problems, put durable processes in place where none exist today, and carry projects from inception through execution largely on your own.

Behavioral health reimbursement is its own discipline — EAP arrangements, session-based benefit limits, authorization requirements, and payer behavior that rarely resembles medical claims. We are looking for someone who has lived in that world and can act as our subject matter expert from day one. As the function grows, there may be a path for this person to take on oversight of a small team, and we are looking for someone who is interested in potentially growing into people leadership — you do not need management experience today, but you should be open to it tomorrow.

We are seeking an individual who thrives working cross-functionally and is passionate about digging into Product, Commercial and Operational processes that tie directly to product monetization. You will be instrumental in organization-wide initiatives related to profitability operations, and in replacing manual, error-prone processes with ones that scale. We want someone who thinks creatively about how to leverage AI to improve how the team works, and who is resourceful about the operational improvements that accelerate cash collections. In summary, we are looking for a self-starter who craves a challenge, moves fast, and questions the status quo — someone who can see the big picture but is equally willing to roll up their sleeves and get their hands dirty. Startup experience is preferred but not a must. The ideal candidate will have experience in health tech, behavioral health, or a provider organization with meaningful behavioral health volume.

Team 

This role sits within the Finance organization and reports into the Senior Director of Revenue Operations (RevOps). The RevOps team is a small but mighty group with a strong growth mindset, who love working cross-functionally and are passionate about helping our members. This team is critical to the path to profitability and takes pride in working on high-visibility, high-stakes projects within the Finance organization. As a Senior Associate you will be one of the most independent operators on the team, trusted to own your scope outright and to raise the bar for those around you.

What you'll be doing:

• Independently own pre-submission, submission and post-submission workflows across the revenue cycle — billing, claim scrubbing, rejections, denials, underpayments, recoupments, reconciliation and A/R follow-up — driving timely resolution and cash acceleration
• Take the lead on directing and delivering timely solutions to moderately complex, loosely-scoped problems aligned to team and company goals, across all billing matters
• Independently put processes, SOPs and SLA standards in place that improve the efficiency, consistency and quality of revenue cycle operations
• Identify systemic trends and root causes in denials and payer behavior, and partner cross-functionally to drive durable fixes rather than recurring rework
• Own leadership-facing reporting on RCM performance — collection rate, A/R days, denial and write-off rates, yield — and clearly communicate trends, root causes, and the changes, support or resourcing needed to improve outcomes
• Identify and implement opportunities to leverage AI and automation to reduce manual operations and accelerate external cash collections
• Work cross-functionally with Accounting and FP&A on month-end close activities 
• Enable Analysts on the team to be successful through mentoring, training and onboarding support, with the opportunity to oversee a small team as the function scales
• Partner with our Intelligence, Data and Product teams to build quarterly roadmaps that align with company-wide goals
• Develop self-serve dashboards that better support Commercial teams and eliminate the need for manual data manipulation
• Work regularly with the Product team on scaling our home-grown billing tooling, and support billing system migrations and implementations end-to-end — requirements, configuration, testing and cutover
• Work closely with Customer Success and Partner Success on all items related to customer and partner pricing, billing and payment; support the project management of setting up new payment structures as we expand into additional solutions
• Own the front-end of the billing lifecycle, including participating in external calls with clients, payers and health plans, representing the company as the reimbursement SME
• Support internal and external audits related to revenue cycle operations — ensuring readiness and compliance, and translating findings into durable process improvements
• Enable Analysts and Associates on the team to be successful through mentoring, training and onboarding support
• Ensure all billing processes and workflows adhere to HIPAA and applicable regulatory and industry standards

What you need to have: 

• Startup or high-growth company experience
• Direct, hands-on experience billing mental and behavioral health services. You should be fluent in behavioral health claims, EAP billing and reauthorization, session-based benefit and clinical package tracking, prior authorizations, and the payer rules and authorization requirements specific to mental health services
• At least 3.5 years of hands-on Revenue Cycle Management experience
• Strong command of the medical claims lifecycle front to back, payer rules, and A/R management best practices
• Demonstrated track record of independently owning projects from initiation through execution
• An interest in growing into people leadership. Prior management experience is not required, but you should want to manage and potentially develop a small team over time.
• Experience using data and reporting to drive operational decisions and performance improvements
• Advanced Excel/Gsheet skills
• Comfort with ambiguity and loosely-scoped problems
• Excellent attention to detail
• Experience working cross-functionally with different teams, and the ability to influence stakeholders outside your reporting line
• Efficient written and verbal communication skills
• Excitement to wear multiple "hats" and problem solve effectively
• Ability to operate effectively in a fast-paced, evolving environment
• Undergraduate college degree

What we would love to see:

• Experience in behavioral health, telehealth, or digital health environments at scale
• Experience implementing process automation, RPA, or technology-enabled workflow improvements within RCM
• Experience leading or supporting a billing system migration or implementation
• Exposure to Medicare/CMS products, delegated credentialing, or payer contracting
• Prior experience mentoring, training or informally leading teammates
• We'd love to see someone who is self-motivated, resourceful and proactive about driving projects to success. Someone who is highly attentive to detail, has a learn-it-all attitude, and isn't afraid to ask questions, take on a new challenge and grow with Sword