Director of Revenue Cycle Management

5 days ago

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Remo

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Description

• Manage the end-to-end coding and billing process for all clinical services (requires a thorough understanding of systems, process, and service-specific coding and billing requirements) • Identify and execute on opportunities for revenue cycle improvement and revenue cycle transformation projects including documentation and coding (e.g. optimizing codes Remo is currently billing, and providing expertise in new codes to be considered under value-based and fee-for-service contracts) • Own reimbursement related issues, including contract/underpayment and denial management • Own Remo billing compliance, policies, procedures, and ensuring adherence and ongoing internal audit of billing compliance, policies, and procedures. • Provide leadership to the revenue cycle management team and build out standard reporting for contracting & credentialing and revenue cycle management KPIs. • Communicate with clinical staff regarding coding and billing best practices, guiding individual and service level improvements, and supporting the organization’s overall financial goals and performance • Partner with the Engineering, Product, and Operations teams to continue to introduce automation to our claims billing processes across value based and fee for service contracts as well as identify and fix any billing issues that arise. • Stay current with regulatory, third-party payor and contractual changes affecting the revenue cycle to ensure compliance. • Interface with and build relationships with key external stakeholders; including other providers, payers, government entities and applicable professional associations

Requirements

• At least 5-7 years of experience in healthcare provider revenue cycle management leading RCM teams. • At least 5-7 years of experience leading RCM with both CMS (Medicare, MA, and Medicaid) and commercial payers • Have experience creating, building and implementing systems from scratch. • Have expertise in telemedicine billing and coding for dementia care, caregiver support, G Codes, etc. Ideally in multiple states. • Experience with value-based contracts -- ideal to have experience with specific alternative payment models (e.g. ACO reach, PCF, full-risk primary care, etc) • Financial management skills, including the ability to financially analyze data for operations, budgeting, auditing, forecasting. • Cash-flow management skills, including forecasting and managing A/R. • A degree in public health or related degree preferred, but not required. • A billing/coding specialist certification

Benefits

• 401(k) with employer matching up to 4% • 100% employer-paid health insurance benefits for employee + family • Dental / vision benefits • Monthly wifi/cell reimbursement • Talkspace • Fertility benefits • 20 days PTO + 11 company holidays • 16 weeks parental leave for birthing parents and 8 weeks parental leave for non-birthing parents • Pregnancy loss leave and bereavement leave