Location: RemoteWho We Are:
At Heal, we believe improving health outcomes starts by meeting patients where they're most comfortable: at home. That’s why we provide value-based, in-home primary care to seniors on Medicare and select Medicare Advantage plans. By connecting our compassionate, patient-focused clinical teams with proprietary, tech-enabled solutions, Heal is transforming the way seniors access healthcare.
Our award-winning doctor house call, telemedicine, and remote monitoring solutions serve patients across 8 states including Georgia, Illinois, Louisiana, New Orleans, New Jersey, New York, North Carolina, South Carolina, and Washington. Having served over 250,000 patients and raised over $200MM in investment capital from the likes of Fidelity, Humana, and other prominent financiers, we now have an eye towards rapidly scaling to a position of market leadership.
At Heal, we believe in creating a culture that is efficient, engaging and full of passion. We take pride in recognizing employees for their hard work and dedication and our CEO is never more than a phone call away. Come help us revolutionize the healthcare experience by putting patients first!
The Director, Revenue Cycle Management - Front End will lead the front end revenue cycle processes (patient registration, insurance verification and eligibility, patient responsibility, authorizations) that lead to more successful financial outcomes and an improved patient experience.
The role leads the front end cross-functional team in supporting all revenue cycle activities (coding and billing) acting as a resource to inform staff on matters pertaining to the front end revenue cycle. This role will partner closely with the call center, clinical and coding and back end billing teams to ensure processes are in place to achieve a clean claims rate and continued patient satisfaction. This position will report directly to the Chief Financial Officer.
Duties and Responsibilities:
- Front end revenue cycle process ownership, including but not limited to: insurance verification, patient registration information, defining/documenting front end policies and procedures, collection of patient and insurance data in EMR and billing, and partnering with call center.
- Work closely with Growth team on strategies to identify insurance information for new patients
- Expected to engage verbally with senior population to ensure a positive patient financial experience
- Co-develop tools and dashboards that are regularly reviewed to ensure performance targets are met for core Front End KPI metrics
- Partner with mid-cycle and back end on the end to end continuum for clean claims submission and managing claims rejections/denials of coordination of benefits, coverage dates, and place of service
- Work with 3rd party vendors to coordinate and monitor all Eligibility/Benefits, Pre-Certification Utilization Review and outcomes for medical necessity
- Support Revenue Cycle Compliance Committee by representing front end at meeting
- Coordinate with internal and external customers to obtain all information needed based on medical criteria from the healthcare teams, insurance and customers to obtain insurance authorization
- Performs and promote interdepartmental integration and collaboration to enhance the continuity of care for patients
- Assists with identification of continuously improving the digital health experience for both patients and the provider community
- Maintains professional relationships with internal and external customers while identifying opportunities for improvement.
Education and Experience:
- 5-7+ years' experience in data analysis, healthcare EMRs and billing, preferably in digital health, EPIC experience is a plus
- Demonstrated knowledge of Healthcare reimbursement/collections, medical billing, ICD10 coding, state and federal regulations, with a strong knowledge of the collections process
- Preference for revenue cycle functions in physician-based services; in both business office, clinical and utilization management departments
- Comprehension and ability to navigate CMS and commercial payer requirements to determine medical necessity
- Excellent verbal and written communication skills for patient financial clearance interactions and internal Heal stakeholders
- Experience managing cross functional teams and communication
- Strong analytical and problem-solving skills, effectively thinking big picture while able to drill down into the details
$120,000 - $150,000 - Depending on Experience. (May vary in Connecticut, Colorado, and New York)
Benefits - Regular Full-Time Employee:
- Competitive Salary
- Remote Work Opportunities
- 3 Weeks Paid Vacation to start
- 1 Week Paid Sick Time
- 100% Company Paid Medical, Dental, and Vision benefits for employee
- 100% Company Paid Short-Term and Long-Term Disability (STD & LTD)
- 100% Company Paid Life Insurance (AD&D)
- WiFi & Cell Phone Stipend
- Parental Leave for six weeks
- HSA & FSA Plans Available
- 401k Plan & Stock Opportunities for Leadership Positions
- 11 Holidays (7 Company and 4 Floating)
- LinkedIn Learning and other educational opportunities
- Employee Assistance Program (EAP)
- Employee Discount Programs
- Additional voluntary benefits, such as pet and legal insurance.
Get Heal (dba “Heal”) recognizes and values the key to success is the experiences and perspectives of people from all walks of life. Heal is proud to be an equal employment opportunity employer to all individual, regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law.