About the Role:

Our client is on a mission to inspire and enable people everywhere to live free of chronic disease. We're seeking a revenue cycle manager to execute and improve their revenue cycle management (RCM) function. The manager will be expected to understand the RCM framework and work with the RCM team in developing effective methods and tools to drive cash collections.

Our client is looking forward to leveraging your professionalism, experience, and expertise to think strategically about how we can improve their revenue cycle platform. This includes not only performing day-to-day tasks but coming up with strategies on how to scale revenue cycle practices in an efficient and effective way. Because of the complex nature of healthcare billing, we are seeking professionals who have the necessary skill sets to grow the business unit.

The manager will work with internal and external stakeholders to ensure all aspects of claims billing and collection processes are in place to support our mission. Your work will ensure that they recover their claims in a timely fashion, our payers are impressed with our service, and our members can focus on improving their health. This position will be at the forefront of defining the company’s processes, best practices, and systems to further support financial growth.

Who They Are:

They are a virtual-first, integrated care provider. They combine the latest clinical protocols with breakthrough behavior science to make it possible for people with chronic conditions to achieve long-term improvements in their health.

Working here, you will find that the leadership is hands-on, collaborative, and supportive. When someone on the team has a new idea, it's acknowledged and appreciated. The company is growing and now is a perfect time to join.

What you’ll do:

• Design and implement RCM processes and systems to minimize claim denial rate and bad debt rate, and to improve cash flow and ensure industry-standard clean claim submission rate
• Responsible for RCM operations and management, including the achievement of Accounts Receivable and Bad Debt Reserve goals to achieve department and company goals
• Educate customers and internal stakeholders on how to integrate with their unique billing model
• Ensure claims and billing generation is completed accurately and timely and reconciles with Accounting records
• Be the go-to person for revenue cycle questions, including participating in cross-functional efforts to increase efficiency and effectiveness of systems and processes related to the revenue cycle
• Ensure all policies, procedures and initiatives are handled in compliance with HIPAA privacy and security regulations
• Process and systems implementation
• Execute the monthly claim generation process and address exceptions
• Strategize on methods to improve all functions of RCM including insurance verification, billing, etc.
• Collaborate with their clearinghouse on all issues related to claims management
• Assist with any new system implementations related to the RCM platform
• RCM operations
• Perform monthly bank and claim reconciliation
• Complete monthly revenue integrity checks
• Oversee and manage billing practices. This includes ensuring claims are not approaching timely filing or appeal windows.
• Investigate, document, and work with finance to execute refunds
• Investigate, document, and take action on denials and/or underpayments
• Ensure account receivables remains accurate and transparent
• Be the main point person for revenue cycle related questions
• Documentation, training, and ongoing communication
• Educate customers and internal stakeholders on how to integrate with the revenue cycle platform
• Mentor and develop RCM framework for additional members if needed
• Create documentation around RCM practices

What we’re looking for:

• 5+ years of experience with revenue cycle systems
• Experience executing revenue cycle management, especially in a healthcare setting
• Knowledge of industry terminology and best practices
• Proficiency in Excel a must
• Proficient in basic accounting and business management knowledge as it relates to revenue cycle
• Knowledge of the US healthcare system, digital health, and the startup work environment
• Ability to develop fantastic relationships with both internal and external stakeholders
• A passion and ability to deliver quality work that meets or exceeds expectations
• Excellent written, verbal, and presentation communication skills
• Demonstrate the ability to thrive in a fast-paced environment with minimal oversight. Flexibility, resilience, and adaptability are key attributes
• Ability to handle repetitive tasks, and continue to find ways to make processes more efficient
• Ability to balance day-to-day execution with long-term priorities
• Ability to engage with all levels of an organization and different types of teams (executive, technical, finance, product, etc.)

Benefits:

• Competitive salary
• Stock options (extended post termination option exercise window for employees who are with us 3 years or more)
• Flexible vacation to help you rest, recharge, and connect with loved ones
• Generous parental leave
• Health, dental, and vision insurance (and above market employer contributions)
• 401k retirement savings plan