Revenue Cycle Manager
Color
United States · Remote
Posted on Thursday, September 12, 2024
Color is a health technology company that makes population-scale healthcare programs accessible, convenient, and cost-effective for everyone. We work with employers, labor unions, national health initiatives, governments, and public health institutions to provide the tools for preventive health and disease management, including cancer early detection, screening, and care management.
Apply to join Color and do the most meaningful work of your career. If you are not sure that you’re 100% qualified but are up for the challenge - we want you to apply!
The Finance team is seeking a seasoned Revenue Cycle Manager with experience in healthcare provider revenue cycle management and a deep understanding of the intricacies of medical claims billing. This leader will be responsible for optimizing our entire revenue cycle process, taking a hands-on approach to managing day-to-day operations. We are looking for someone who thrives in cross-functional collaboration, working closely with Sales, Legal, Finance, Product, and Engineering teams to drive business outcomes and ensure financial health. Your expertise will be key in improving cash flow, reducing denials, and maintaining compliance with healthcare regulations, making a significant impact on the company’s growth and success.
How You'll Contribute:
- Oversee the end-to-end revenue cycle process, including patient registration, billing, coding, charge capture, collections, and payment posting.
- Own end to end claims cycle including documentation and coding (optimizing codes we are currently billing, expertise in FFS billing and telehealth codes).
- Develop and implement strategies to optimize revenue cycle performance, reduce denials, and improve cash flow.
- Own the entire billing life cycle for new customers from taking part in external calls with customers, payer integration, health plans, partners and representing Color as the Revenue Cycle subject matter expert.
- Communicate cross-functionally with the Sales and Customer Success teams on upcoming customer deals/launches & ensuring that customer requirements are being fulfilled and escalating any issues that arise with specific accounts.
- Work with self-insured employers, health plans and third party administrators to set up claims billing workflows
- Manage patient billing inquiries and resolve escalated issues related to billing, payments, and insurance claims.
- Manage internal Color fee schedule and charge description master (CDM).
- Build out reporting for revenue cycle KPIs,including claim denial rates, claim write-offs, charge lag, time to cash, etc.Develop and implement revenue cycle specific policies in regards to: payor follow-up, appeals, write-offs, rejected claims, etc. and implement policies and procedures to ensure compliance and mitigate risk.
- Oversee third party RCM vendor and operation and maintenance of revenue cycle management software and systems.
- Partner with Engineering, Product and Operations teams to ensure seamless integration and functionality of revenue cycle systems and support data reconciliation and reporting
- Train and educate team members on RCM best practices and industry benchmarks to improve Revenue Cycle metrics and build team accountability.
- Ensure compliance with all federal, state, and local regulations, including HIPAA, CMS, and payer-specific guidelines.
- Stay up-to-date with changes in healthcare laws and regulations that impact revenue cycle processes.
- Continuously work to identify areas of improvement and develop processes and documentation in the Company’s revenue cycle.
Our Ideal Candidate Will Have:
- 5+ years of experience in healthcare provider revenue cycle experience
- Prior experience with digital health companies
- Experience building out systems and processes
- Persistence when working/communicating with payers
- Experience working cross-functionally with different teams
- Experience project managing internal projects
- Working knowledge of industry best practices in Revenue Cycle processes: billing, charge capture, contractual adjustments, third-party reimbursements, and collections and cash management
- Fundamental knowledge of revenue integrity (i.e. CPT and ICD-10 coding) and documentation requirements for billing and compliance
- Knowledge of payor policies, payor plans and processes related to coding and claims billing
- Expertise with fee for service billing/coding & telehealth coding/billing.
- Comfortable working with the ambiguity of a fast-paced startup
- Efficient written and verbal communication skills
- Attention to detail, exceptional organizational and problem-solving skills
- Advanced Excel skills
Nice to Have:
- Experience working with Big Query, Metabase and ability to write SQL queries to extract, manipulate and analyze data
- Degree in accounting, finance or business preferred, but not required
What We Offer:
- 💰 Competitive salary
- ✨ Comprehensive medical, dental, vision, life, and disability benefits
- 📈 401k match
- 📝 Monthly phone and wifi stipend for employees, annual ergonomic stipend
- 🏝 Generous vacation policy, paid holidays and company-wide recharge days
- 🍼 Equal paid parental leave for birthing and non-birthing parents
- Free cancer screening and prevention resources for employees and their adult dependents
Base Salary Range: The actual base pay is dependent upon many factors, such as: work experience, market data, skills, geographic location, and business need. The base pay range is subject to change and may be modified in the future. This role may also be eligible for bonus, equity, and benefits.
Color is an equal opportunity and affirmative action employer. In accordance with anti-discrimination law, it is the purpose of this policy to effectuate these principles and mandates. Color prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability status, protected veteran status, or any other characteristic protected by law. Color conforms to the spirit as well as to the letter of all applicable laws and regulations. We are also committed to providing reasonable accommodations for qualified applicants with disabilities in our recruitment process.