Senior Revenue Cycle Specialist

Cartwheel is an early-stage company building a new kind of mental health program for kids that puts schools at the center. We see our role as supporting school staff who see kids every single day. Instead of going around them, we collaborate with them. This means: 

• Earlier intervention
• Higher student and family engagement in care
• Better coordination among the trusted adults in a student’s life 

Kids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live. If you join Cartwheel, you’ll help make this vision a reality for millions of students across the country. We’re backed by top investors including Menlo Ventures, Reach Capital, General Catalyst, BoxGroup, and Able Partners, and we're looking for mission-driven teammates to join our team.

ABOUT THE ROLE

Since our founding in 2022, we have grown to serve more than fifty school districts across six states, providing care to thousands of students and families.

Cartwheel processes a high and growing volume of behavioral health claims across three revenue streams — school district partners, health plans, and members. Without dedicated support, denial and rejection recovery opportunities go unworked and result in preventable revenue loss. This role exists to close that gap.

As our Senior Revenue Cycle Specialist, you'll own the workflows that directly protect Cartwheel's bottom line: investigating and resolving denials and rejections, submitting corrected claims and appeals, managing aging AR, and keeping payer follow-up moving as claim volume grows. You'll also serve as the internal expert on billing compliance and payer requirements across all three revenue streams.

This role is right for a senior behavioral health billing professional who sees a significant denial and rejection backlog as an opportunity — someone who digs into root causes, builds the systems to prevent recurrence, and wants to scale an RCM operation, not just maintain one.

Role Type: Salaried, full-time
Salary: $55,000 - $75,000
Location: Remote
Start: Summer 2026

• Own the full AR cycle: payment posting, cash reconciliation, aging management, and payer follow-up across district, health plan, and answer member inquiries
• Own denials and rejections recovery across a high-volume behavioral health claims portfolio — investigate root causes, submit corrected claims and appeals, track outcomes, and drive systemic fixes to improve clean claim rates over time
• Investigate and resolve complex claim denials and rejections — identify root causes, submit corrected claims and appeals, track outcomes, and recommend systemic fixes to improve clean claim rates
• Review, validate, and submit Massachusetts CANS assessments in compliance with state and payer requirements
• Serve as the internal subject matter expert on payer requirements, billing regulations, and compliance standards — fielding escalations from clinical and operations teams
• Respond to patient, provider, payer, and internal billing inquiries with professionalism and empathy
• Analyze AR trends, denial patterns, and reimbursement activity to surface insights and drive continuous process improvement
• Identify and lead operational improvements that enhance billing efficiency, revenue recovery, and member experience

• 3+ years of experience as a Billing Specialist, Accounts Receivable Specialist, Payment Coordinator, Revenue Cycle Specialist, or similar role required.
• 1+ years of behavioral health billing experience.
• Deep expertise in denials management, appeals, corrected claims, and AR follow-up
• Strong working knowledge of healthcare billing regulations, payer requirements, and compliance standards
• Proven ability to independently identify billing issues, investigate root causes, and implement fixes — not just escalate
• Experience with payment posting, cash reconciliation, and resolving complex payment discrepancies for members

Preferred

• Experience with Apero and/or Healthie EMR
• Massachusetts CANS experience

The above is a summary of the role, not an exhaustive list. If you think that you have most of the above but not everything, please apply. We'd love to hear from you!

Our hope is that Cartwheel will be your best career decision! In addition to tackling one of the biggest challenges of our time, at a company well-positioned to do so, you’ll have: 

• Equity ownership stake in the company
• High-quality health insurance with a $0 monthly premium option for employees
• Dental, Vision, and Employer-Sponsored Life Insurance
• 4 weeks of paid PTO (3 weeks any time  + 1 week office closure in December)
• Sick Leave + Holidays
• 401K with up to 2% employer match
• $500 annual educational stipend
• Team-based culture with mission-driven colleagues who will go to bat for you