Director – Revenue Cycle Management
Posted on 8/12/2022
- Demonstrated knowledge of Healthcare reimbursement/collections, medical billing, ICD10 coding, state and federal regulations, with a strong knowledge of the collections process
- Preference for revenue cycle functions in physician-based services; in both business office, clinical and utilization management departments
- Comprehension and ability to navigate CMS and commercial payer requirements to determine medical necessity
- Excellent verbal and written communication skills for patient financial clearance interactions and internal Heal stakeholders
- Experience managing cross functional teams and communication
- Strong analytical and problem-solving skills, effectively thinking big picture while able to drill down into the details
- Front end revenue cycle process ownership, including but not limited to: insurance verification, patient registration information, defining/documenting front end policies and procedures, collection of patient and insurance data in EMR and billing, and partnering with call center
- Work closely with Growth team on strategies to identify insurance information for new patients
- Expected to engage verbally with senior population to ensure a positive patient financial experience
- Co-develop tools and dashboards that are regularly reviewed to ensure performance targets are met for core Front End KPI metrics
- Partner with mid-cycle and back end on the end to end continuum for clean claims submission and managing claims rejections/denials of coordination of benefits, coverage dates, and place of service
- Work with 3rd party vendors to coordinate and monitor all Eligibility/Benefits, Pre-Certification Utilization Review and outcomes for medical necessity
- Support Revenue Cycle Compliance Committee by representing front end at meeting
- Coordinate with internal and external customers to obtain all information needed based on medical criteria from the healthcare teams, insurance and customers to obtain insurance authorization
- Performs and promote interdepartmental integration and collaboration to enhance the continuity of care for patients
- Assists with identification of continuously improving the digital health experience for both patients and the provider community
- Maintains professional relationships with internal and external customers while identifying opportunities for improvement
- 5-7+ years' experience in data analysis, healthcare EMRs and billing, preferably in digital health, EPIC experience is a plus
With their unique ability to see all aspects of patients' lives, Heal will improve health outcomes, strengthen provider-patient relationships, and make primary healthcare affordable and accessible, because everyone deserves to Heal.
- Work from home remote opportunities
- Three weeks paid vacation
- Employer paid comprehensive health plans
- Competitive salary, stock options and 401(k)
- Six weeks parental leave
- FSA plans and employer paid
- Short Term Disability
- Relationship-Focused - We practice what we preach. Seamless communication comes from building healthy and trustworthy relationships with our teammates and patients.
- Patient-First - Our patients give us purpose. Patient-care, repairing the healthcare system, and providing an improved quality of life to all is our aspiration.
- Do The Right Thing - We are open, honest and act with integrity in every situation. We prioritize the safety of all the personal information and data across our platform.
- Innovation-Infused - We see beyond the horizon and believe in a brighter future through the power of technology. We always seek new solutions and are open to try new things.
- Empathy - Heal was born from the understanding of the need for comprehensive, quality, and convenient healthcare. Empathy is woven into the fabric of who we are as we demonstrate interest, care and concern for others.