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Job description
Founding Chief Operating Officer | Finale RCM
Autism Care Revenue Cycle Management · Full-Time · Executive Leadership · Remote/Hybrid
About Finale RCM
Finale RCM is a technology-enabled revenue cycle management company built exclusively for the autism care and ABA therapy space. We exist to remove the billing and administrative burden from providers so they can focus on what matters most - delivering life-changing care.
We don't just manage revenue cycles. We partner with ABA providers to protect their mission, powered by technology, data, and a relentless one-team culture.
The Opportunity
We are seeking a Founding COO to join at the ground floor and build the operational engine of our business. This is a rare opportunity to shape culture, systems, and strategy from day one - alongside a founder-led leadership team that moves fast, cares deeply, and plays the long game.
As COO, you will be the operational architect of Finale RCM - translating vision into execution across every function of the business. You'll lead onshore and offshore delivery teams, deploy AI-driven automation, and build a customer success culture that treats every provider like a true partner.
What You'll Own
End-to-End RCM Operations - Full accountability for VOB, credentialing, contracting, prior authorization, denial management, appeals, and compliance - with ownership of quality, throughput, and client outcomes.
Customer Success - Champion a partnership-first model where clients experience Finale as an extension of their internal team. Drive retention, satisfaction, and growth through proactive, high-touch engagement.
Team Building - Recruit, develop, and lead high-performing onshore and offshore teams. Build the management layer that scales with the business while preserving culture and accountability.
Technology & Automation - Partner with technology leadership to deploy AI agents, RPA, and analytics tools that reduce manual effort, accelerate reimbursement, and surface actionable insights for clients.
Data & Analytics - Establish operational KPIs, dashboards, and reporting cadences that give clients and internal teams full visibility into performance, cash flow, and payer trends.
Payer Relations - Build and steward relationships with major commercial payers, Medicaid managed care organizations, and regional plans in the autism/ABA space to improve contracting outcomes and reduce friction.
Compliance & Risk - Ensure all operations adhere to HIPAA, payer guidelines, and state-specific regulatory requirements, with proactive audit readiness and documented policies.
Scaling Infrastructure - Design the workflows, SOPs, and technology stack that allow Finale to scale without sacrificing the white-glove service experience.
What You Bring
10 years of progressive operations leadership in healthcare RCM with direct accountability for revenue cycle outcomes
Deep expertise in ABA billing - CPT 97xxx series, payer-specific authorization workflows, and behavioral health compliance
Established payer relationships and negotiation experience with commercial insurers and Medicaid MCOs in the autism/behavioral health space
Proven track record building and managing onshore and offshore RCM teams at scale
Hands-on experience implementing AI agents, automation tools, and RCM platforms (CentralReach, Waystar, Chorus, Passage, Rethink, or similar)
Data-driven operator comfortable designing dashboards and using analytics to drive decisions and client conversations
Startup mindset - thrives in ambiguity, builds from scratch, leads by doing
Partnership mentality - genuinely believes client success is company success
Areas of Mastery
Verification of Benefits (VOB)
Prior Authorization
Provider Credentialing
Payer Contracting & Negotiation
Denial Management & Appeals
Billing Compliance
Offshore Team Management
AI Agent Deployment
RCM Analytics
Customer Success Strategy
Workflow Automation
HIPAA Compliance
Why Finale RCM
Ground-floor influence - shape the company as a founding member
Mission-aligned work - serve ABA providers delivering life-changing therapy to children and families
Category-defining niche - autism care RCM is underserved, fast-growing, and ready for a tech-enabled leader
One-team culture - clients are partners, offshore colleagues are teammates
Technology-first foundation - AI and automation are core to our model from day one
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Worksite address
new york, NY, 10261, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.