Billing Operations Lead Full Time

You will build and lead Crosby Health’s billing operations from the ground up. This is a player-coach role — you’ll own billing KPIs, data/reporting, and operations while managing a Senior Billing Analyst. You are equally responsible for billing operational outcomes and for making our billing product better. You’ll work cross-functionally with data engineering and product teams daily, and you’ll prototype and document everything.

Responsibilities

• Manage and develop the Senior Billing Analyst; oversee the Denials & Appeals Specialist
• Own end-to-end billing operations: claim lifecycle, denials, appeals, collections
• Define and enforce SOPs for denial management, escalation, and appeals
• Own weekly KPI reporting and drive root-cause analysis on misses
• Build and maintain billing dashboards and reports in Metabase or equivalent BI tools
• Produce internal and external billing performance reports
• Partner with data engineering to ensure billing data pipelines are accurate and comprehensive
• Conduct monthly data quality audits across billing tables
• Serve as the billing domain expert in product planning sessions; translate operational pain into prioritized feature requests in Linear
• Write product specs, prototype workflows, and draft PRDs for billing product improvements
• Maintain thorough documentation of every billing process, payer rule, and team workflow
• Manage payer-specific rules and maintain a denial taxonomy
• Continuously identify opportunities to automate manual billing work through the product

Requirements

• 7+ years in U.S. healthcare billing / Revenue Cycle Management, with significant data and reporting ownership
• 2+ years managing billing or RCM analysts
• Deep knowledge of Medicare, Medicaid, and commercial payer billing (post-acute or therapy experience strongly preferred)
• Strong analytical skills — proficient in SQL, Excel/Sheets, and at least one BI tool (Metabase, Looker, Tableau)
• Native user of Linear and Slack — you live in these tools daily
• Excellent written communication — you can write clear specs, SOPs, and documentation
• Experience translating operational problems into product requirements
• Willingness to work U.S.-overlapping hours

Nice to Have

• Experience at a healthcare SaaS or healthtech company
• Familiarity with BigQuery, Airflow, dbt, or data warehousing concepts
• Understanding of CMS programs (GUIDE, PCM, chronic care models)
• Experience building billing operations from scratch
• Prototyping experience (Figma, Notion, or similar)