Billing Manager (Pediatric Therapy)

About Little Land
Little Land Pediatric Therapy & Play Gym is a multi-state pediatric therapy company with corporate clinics in Cedar Park, TX and Arcadia, CA. We provide OT, PT, speech-language pathology, and ABA services to children and families.
Revenue cycle is the financial backbone of our clinical operation. We need someone who takes that seriously and knows how to run it.
The Role
We're hiring a Billing Manager to own the full revenue cycle function across both corporate locations. This is not a back-office role — you will be a core part of the leadership team, managing our billing staff, driving clean claims, reducing denials, and owning collections across Cedar Park and Arcadia.
You will manage a billing team that spans both US and offshore staff and report directly to the CEO.

What You'll Own
Clinical Billing

• Own the end-to-end billing process across OT, PT, ST, and ABA — Cedar Park and Arcadia
• Ensure claims are submitted accurately and on time across all payers — Medicaid managed care, TMHP, Medi-Cal, commercial insurance, and private pay
• Manage authorization tracking and ensure no claims fall through on expired or missing auths
• Maintain clean billing records and audit regularly for accuracy and compliance

Collections & Denials

• Own the collections function — track outstanding AR, manage aging, and drive resolution
• Build and manage a denial management process — identify patterns, root-cause issues, and close gaps upstream
• Set and track KPIs for clean claim rate, denial rate, days in AR, and collection rate
• Escalate payer issues and credentialing problems proactively

Team Management

• Directly manage billing staff across Cedar Park and Arcadia — including offshore team members
• Set clear expectations, hold regular check-ins, and develop your team's skills and accuracy
• Build a billing function that runs consistently regardless of payer mix or location

Systems & Reporting

• Own billing workflows within our practice management system (Axis Ops)
• Report regularly to CEO on revenue cycle health — AR aging, denial trends, cash collections
• Identify and implement process improvements that reduce friction and increase collections velocity

Who You Are

• 3–5+ years in medical billing, revenue cycle management, or practice management — pediatric therapy, outpatient rehab, or specialty practice strongly preferred
• You know Medicaid managed care, TMHP, and/or Medi-Cal — not just commercial billing
• You've managed a billing team before and know how to hold people accountable to accuracy
• You are metrics-driven — you track the numbers that matter and act on them
• Comfortable managing remote and offshore staff
• ABA and therapy-specific billing experience is a significant plus

Compensation & Benefits

• Base salary based on experience
• Full-time, salaried exempt
• PTO and paid holidays
• Health benefits (details during offer process)

Little Land is an equal opportunity employer.