Revenue Cycle Manager
knownwell
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Posted 6+ months ago
Meet knownwell, weight-inclusive healthcare for all. Join a dynamic company that is changing the way care is delivered to patients with obesity. knownwell is a weight-inclusive healthcare company offering metabolic health services, primary care, nutrition counseling and behavioral health services for anyone of any size. Our hybrid model allows for both in-clinic and virtual care to bring support to patients where and when they need it. To learn more about our recent Series A funding, led by Andreessen Horowitz, please check out this article.
We are seeking a highly skilled Revenue Cycle Manager (RCM) to oversee and optimize our revenue operations. The ideal candidate will have extensive experience in healthcare claims management, particularly in primary care settings. Knowledge of Athena software and proficiency in adjudicating commercial, Medicare, and Medicaid claims are essential for this role. Experience in obesity medicine is a plus, though not required.
Responsibilities:
- Manage End-to-End Revenue Cycle: Oversee the entire revenue cycle process from patient registration and insurance verification to claims submission, payment posting, and collections.
- Billing and Coding Oversight: Ensure accurate and compliant billing and coding practices, including telehealth services, preventative counseling codes, remote patient monitoring, and dietitian coding.
- Patient Billing Support: Work directly with patients to address billing inquiries, resolve disputes, and provide guidance on payment options and financial assistance programs.
- Claims Adjudication: Lead efforts in adjudicating claims with commercial payors, Medicare, and Medicaid to maximize reimbursement while adhering to regulatory guidelines.
- Denial Management: Proactively manage and appeal claim denials, working closely with payors and internal stakeholders to identify root causes and implement corrective actions.
- Revenue Cycle Analysis: Monitor key performance indicators (KPIs) related to revenue cycle metrics, such as days in accounts receivable (AR), first-pass resolution rate, and denial rate. Utilize data analytics to identify trends, inefficiencies, and opportunities for improvement.
- Compliance and Regulations: Stay abreast of healthcare regulations, billing requirements, and industry changes to ensure compliance and mitigate risks related to revenue cycle operations.
- Vendor Management: Collaborate with external vendors providing RCM services, ensuring service level agreements (SLAs) are met and driving continuous improvement in vendor performance.
- Staff Development: Provide leadership, mentorship, and training to the full knownwell team (including clinicians and front office staff), fostering a culture of accountability, teamwork, and professional growth.
- Process Optimization: Continuously review and streamline revenue cycle processes and workflows to enhance efficiency, reduce costs, and improve overall revenue performance.
- Financial Reporting: Prepare regular reports and presentations for executive leadership, highlighting revenue cycle performance, trends, and strategic recommendations.
- Cross-Functional Collaboration: Partner with finance, operations, clinical teams, and technology to integrate revenue cycle initiatives with broader organizational goals and initiatives.
Qualifications:
- Bachelor’s degree in Healthcare Administration, Business Administration, or a related field (Master’s degree preferred).
- 4+ years of progressive experience in revenue cycle management within healthcare, with a focus on primary care.
- Strong proficiency with Athena software and other relevant RCM tools.
- Proven track record of successfully managing commercial, Medicare, and Medicaid claims.
- Familiarity with telehealth, preventative counseling codes, remote patient monitoring, anddietitian coding preferred.
- Experience in managing external vendors in the RCM space.
- Excellent analytical skills with the ability to interpret financial data and trends.
- Strong leadership and communication skills, with the ability to motivate and develop a high-performing team.
- We are unable to sponsor visas currently, so you are authorized to work in the United States.
We offer a competitive salary, comprehensive benefits package, and the opportunity to be part of a purpose-driven organization that is dedicated to making a positive impact on the lives of patients. If you are an ambitious and experienced design leader who is passionate about transforming healthcare and creating meaningful change, we invite you to apply and join our dynamic team. Interested in joining us? Please send us a note at hiring@knownwell.health
knownwell, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
This job is no longer accepting applications
See open jobs at knownwell.See open jobs similar to "Revenue Cycle Manager" Flare Capital Partners.