Lead – Revenue Cycle Management
Updated on 5/24/2023
Durham, NC, USA
Experience Level
Desired Skills
Data Analysis
  • Bachelor's degree in business, finance, economics, health policy, or other related field or equivalent work experience required
  • Current certification as a Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent, preferred
  • 5+ years of relevant work experience with proven track record of designing and building healthcare revenue cycle management solution products and workflows
  • Risk adjustment documentation and coding expertise
  • Demonstrated knowledge of CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts
  • Highly organized and proactive in raising questions around clarity, prioritization, blockers, and other points to drive assigned tasks forward
  • Strong leadership skills
  • Excellent written and verbal communication skills
  • Demonstrated ability to manage without explicit authority
  • Demonstrated ability to consult primary care providers and practice stakeholders
  • Excellent understanding of coding guidelines
  • Understanding of fee-for-service and value-based contract principles
  • Excellent critical thinking, organizational, and time management skills
  • Comfortable tackling ambiguous problems with a high level of autonomy
  • Thorough understanding of medical coding guidelines and regulations including compliance, reimbursement and the impact on fee-for-service contracts, and the impact of diagnosis documentation on risk adjustment payment models
  • Implement solutions that support Aledade partner practices in billing and coding activities
  • Execute go-to-market tests for new offerings
  • Lead cross-functional operations to drive improved outcomes
  • Manage relationships with Aledade partner practices
  • Use data to identify practices that could benefit from Aledade services
  • Partner with practices to understand billing and coding workflows and identify opportunities for process improvement
  • Engage with physicians and practice staff on recommendations that improve business functions, accurately document visits, and allow for high-quality patient care
  • Serve as an ongoing resource for Aledade partner practices on billing and coding
  • Partner with business intelligence and impact analytics teams on data insights needed to validate business case inputs and to monitor outcomes
  • Develop and/or contribute to financial models to evaluate future revenue and costs associated with RCM liaison services, under the direction of New Ventures leadership
  • Manage & lead billing and coding related projects, including tracking key metrics across initiatives and driving cross-functional team collaboration
  • Identify trends across practices and provide feedback on the best course of action to improve billing and coding practices

501-1,000 employees

Primary care physician platform