Practice Operations Manager - Remote, Contract to Hire at Sunday Health

About Sunday Health
Sunday Health is a growing healthcare delivery startup focused on building a modern care model for cognitive health. We provide proactive, patient-centered care for individuals concerned about or living with mild cognitive impairment (MCI) and early-stage dementia. Our team is committed to helping people extend their personal agency for as long as possible. We are seeking a highly skilled and motivated professional to join us in this vital role.

About the Role
As our first-ever Practice Operations Manager, you will play a critical role in supporting the operational success of Sunday Health. This position combines critical business responsibilities for managing provider licensing and credentialing processes, managing medical coding and billing, and providing expertise in operations management related to day-to-day operations of our hybrid clinic. Additionally, this role will own key elements of our business operations, such as insurance, compliance oversight, and all processes to help ensure our practice runs smoothly and efficiently.

The position reports to the Senior Director of Clinical Services and will interact with Sunday Health’s CEO as we are a small group. The role is designed as a 30-hour-a-week contract position for the first 6-9 months and is expected to move to a full-time role thereafter, though we can be somewhat flexible to meet your needs.

Your work will directly impact the success of our growing organization – and, by extension, patients and their loved ones – by enhancing access to care, improving operational efficiency, and ensuring compliance as we expand our services.

Key Responsibilities

• Credentialing and Enrollment Management:
  • Manage credentialing and payor enrollment for clinical providers and PC entities, including tracking renewals and ensuring timely submissions.
  • Maintain up-to-date records and oversee compliance with state and federal licensing and credentialing requirements.
  • Act as the primary liaison between the practice and insurance payors to streamline enrollment and contract processes.

• Billing and Revenue Cycle Oversight:
  • Oversees accurate coding (ICD-10, CPT, HCPCS, E&M) and timely claims submission.
  • Monitor claim denials, rejections, and collections, implementing solutions to optimize reimbursement.
  • Conduct periodic audits to maintain compliance with billing regulations and documentation standards.
  • Collaborate with providers to ensure proper documentation supports coding accuracy.
  • Support month-end and ad hoc financial and reporting activities.
• Clinical Business Operations Management
  • Facilitates new employee and clinician onboarding, training, and ongoing support to ensure staff are equipped to meet clinic standards and goals.
  • Monitors compliance with health and safety regulations, as well as organizational policies.
  • Manages operational escalations and troubleshooting issues related to scheduling, patient communication, or care delivery.
  • In collaboration with other Sunday Health team members, perform other duties as needed
  • Collaborate with leadership to evaluate and optimize business workflows, identify trends, and implement data-driven strategies.

• Compliance and Reporting:
  • Ensure adherence to state and federal healthcare regulations, including billing, credentialing, and operational standards.
  • Maintain accurate documentation of compliance with licensing, credentialing, and coding standards.
  • Support preparation for regulatory audits and accreditation reviews.
  • Provide routine reports on operational performance, billing metrics, and referral trends to leadership.
  • Assure compliance with HIPAA training and requirements
• Patient Communication, Referrals, and Scheduling:
  • Oversee referral workflows to ensure timely follow-up, accurate scheduling, and streamlined patient onboarding.
  • Support care navigators in managing patient inquiries, referrals, and follow-ups to enhance patient engagement.
  • Implement processes to assess and prioritize patient referrals as qualified leads for the practice.
  • Ensure a patient-first approach in all communication, creating a seamless and supportive experience.

Required Qualifications

• Bachelor’s degree in a related field and a minimum of 3 years of experience in healthcare licensing, credentialing, and coding.
• Thorough knowledge of ICD-10, CPT, and HCPCS coding systems and healthcare reimbursement methodologies.
• Certified Coding Specialist (CCS), Certified Risk Coder (CRC), or equivalent certification from AAPC or AHIMA and Certified Professional Biller (CPB) certification are highly valued.
• Experience with E&M codes, principal illness navigation (PIN) codes, and chronic care management (CCM) codes.
• Strong understanding of state and federal regulations related to licensing, credentialing, and coding.
• Experience with electronic health record (EHR) systems.
• Excellent organizational, analytical, and communication skills.
• Ability to manage multiple tasks and priorities while maintaining accuracy and efficiency.

Preferred Qualifications

• Experience with Google Suite and advanced reporting tools.
• Familiarity with compliance and auditing processes related to healthcare credentialing and coding.
• Experience working in early-stage healthcare startups or embody a growth mindset.
• Genuine team player.

If you’re passionate about making a difference in healthcare delivery and thrive in a dynamic, mission-driven environment, we’d love to hear from you!