Revenue Cycle Manager
Posted on 2/22/2023
Remote in USA
Experience Level
  • 5+ years of experience with revenue cycle systems
  • Passion for Omada's mission
  • Knowledge of the US healthcare system and the startup work environment
  • Knowledge of industry terminology and best practices
  • Ability to develop fantastic relationships with both internal and external stakeholders
  • Ability to engage with all levels of an organization and different types of teams (executive, technical, finance, product, etc.)
  • Intermediate to advanced Excel skills
  • Attention to detail and exceptional organizational skills
  • Excellent written, verbal, and presentation communication skills
  • 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
  • Proficient about basic accounting and business management knowledge as it relates to revenue cycle
  • Design and implement RCM processes and systems, with a focus on our Physical Therapy program to improve cash flow and ensure industry standard clean claim submission rate
  • Educate customers and internal stakeholders on how to integrate with Omada's unique billing model
  • Project manage cross-functional efforts to increase efficiency and effectiveness of systems and processes related to the revenue cycle
  • Create and implement policies and procedures that not only improve reimbursement but also improve the user experience
  • Ensure claims and billing generation is completed accurately and timely and reconciles with Accounting records
  • Provide feedback on Omada's CPT code strategy and ensure our virtual-first healthcare services can be accurately billed with appropriate codes
  • Build out Accounts Receivable and Bad Debt Reserve goals to achieve department and company goals
  • Process and systems implementation
  • Devise method and reporting to monitor, assess, and act on KPIs
  • Internally report on key revenue cycle metrics such as claim denials or underpayments, but also identify ways to improve and avoid these moving forward
  • Participate in claim submission and follow-up
  • Strategize on methods to improve all functions of RCM including insurance verification, billing, etc
  • Collaborate with Omada's clearinghouses on all issues related to claims management
  • Partner with the RCM Director, Product, and Engineering on future system implementations and integrations
  • Identify opportunities for automation and unlocking opportunities at scale
  • RCM operations
  • Identify and troubleshoot software-related billing issues
  • Partner with the RCM team to devise bank reconciliation, refund, and follow-up processes for the MSK program
  • Troubleshoot and correct any ad-hoc claim rejections, verify user eligibility, and re-submit claims accordingly
  • Investigate, document, and take action on denials and/or underpayments
  • Optimize existing processes for collections, especially member responsibility
  • Monitor member collections AR and respond to escalations
  • Documentation, training, and ongoing communication
  • Communicate cross-functionally with Commercial teams as well as external stakeholders on how to integrate with Omada's revenue cycle platform
  • Propose policies, such as bad debt for Omada's Physical Therapy offering
  • Create robust documentation around RCM practices at Omada
  • Start with Trust. We listen closely and we operate with kindness. We provide respectful and candid feedback to each other
  • Seek Context. We ask to understand and we build connections. We do our research up front to move faster down the road
  • Act Boldly. We innovate daily to solve problems, improve processes, and find new opportunities for our members and customers
  • Deliver Results. We reward impact above output. We set a high bar, we're not afraid to fail, and we take pride in our work
  • Succeed Together. We prioritize Omada's progress above team or individual. We have fun as we get stuff done, and we celebrate together
  • Remember Why We're Here. We push through the challenges of changing health care because we know the destination is worth it
Desired Qualifications
  • Knowledge of physical therapy billing practices
  • Experience in digital health
  • Experience in B2B2C healthcare
  • Experience with clearinghouse integrations or APIs with external partners
Omada Health

201-500 employees

Digital care solution
Company Overview
Omada aims to inspire people to make lasting health changes on their own terms. They partner with health plans and employers to equip members with personalized tools, resources, and support to improve their health one step at a time.
  • Remote first - Join Omada from anywhere in the US. No matter where you’re located, we budget for travel so your team can come together.
  • Flexible vacation - Invest in yourself and your loved ones with flexible time away and monthly wellness days.
  • Parental leave - We support all new parents with competitive leave policies and flexible schedules upon return.
  • Omada program - Join our best-in-class program to reach your health goals, and invite a loved one to join you too.
  • Meeting-free days - Every Wednesday afternoon, we observe company-wide focus time with nothing on the calendar.
  • Resources to thrive - Invest in inclusion with resource groups, equity training, and a cross-functional team dedicated to belonging.
Company Core Values
  • Seek context
  • Act boldly
  • Deliver results
  • Succeed together
  • Remember why we're here
  • Start with trust