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Full-Time

Claims & Billing Manager

Posted on 7/9/2024

Rightway

Rightway

201-500 employees

Personalized healthcare navigation and support platform

Hardware
Healthcare

Compensation Overview

$75k - $90kAnnually

Senior, Expert

Denver, CO, USA

Category
Financial Accounting
Accounting
Required Skills
Data Analysis
Requirements
  • 5+ years of healthcare billing or claims processing experience
  • 3+ years of contact center management experience preferred, but not required
  • Strong understanding of benefit structures, adjudication rules, EOBs, etc.
  • Bachelor’s Degree in Management or Healthcare highly preferred
Responsibilities
  • Lead, motivate, coach, and mentor a team of Claims & Billing Specialists
  • Drive KPI Performance
  • Assign, review, and monitor employee workload
  • Perform reviews of performance analytics
  • Develop, update, and maintain Standard Operating Procedures
  • Work in cross-functional teams for training, quality, and Product improvements
  • Serve as a subject matter expert for internal teams
  • Conduct coaching sessions, quality reviews, and performance evaluations
  • Interview, hire, and onboard new team members
  • Handle escalations and ensure compliance with policies and regulations
  • Support new organization launches and program growth
  • Support program growth and efficiency through operational projects

Rightway Healthcare provides a comprehensive consumer healthcare ecosystem designed to help employees navigate the complex healthcare system. The company pairs each employee with a dedicated care team, which includes physicians, nurses, and clinical pharmacists, to offer personalized support through a centralized mobile platform. This team serves as a single point of contact for all healthcare needs, guiding users to make informed decisions about their care. Rightway partners with employers to include its services in employee benefits packages, aiming to reduce healthcare spending while improving health outcomes. The RightwayRx platform enhances this experience by offering essential healthcare resources and analytics to track employee engagement. The goal of Rightway is to optimize healthcare spending and improve the overall healthcare experience for employees.

Company Stage

Series C

Total Funding

$238.7M

Headquarters

New York City, New York

Founded

2017

Growth & Insights
Headcount

6 month growth

3%

1 year growth

23%

2 year growth

56%
Simplify Jobs

Simplify's Take

What believers are saying

  • Rightway's recent $109M funding round indicates strong investor confidence and provides substantial capital for growth and innovation.
  • Recognition as one of the Best Places to Work in both 2023 and 2024 highlights Rightway's commitment to a positive and inclusive workplace culture.
  • Partnerships with major companies like Amazon's One Medical and Kindbody expand Rightway's service offerings and market reach, enhancing its value proposition to employers.

What critics are saying

  • The recent data breach affecting Davis Polk and Okta employees could undermine trust and damage Rightway's reputation in the market.
  • The competitive landscape in healthcare navigation and pharmacy benefits management is intense, requiring continuous innovation to maintain a competitive edge.

What makes Rightway unique

  • Rightway's unique approach of pairing employees with dedicated care teams for personalized healthcare navigation sets it apart from traditional healthcare solutions.
  • The RightwayRx platform's proactive drug search feature empowers users to make informed decisions about their medication costs, a capability not commonly found in other healthcare navigation platforms.
  • Rightway's business model focuses on delivering ROI for employers by reducing healthcare spending and improving employee health outcomes, which is a compelling value proposition in the employee benefits market.
INACTIVE