Revenue Cycle Manager – Care Management Billing

🕒 Outubro 20

🌐 Estados Unidos, Canadá – Remoto

🇺🇸 Estados Unidos – Remoto (EUA) 🇨🇦 Canadá – Remoto

💵 $90.000 - $100.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 20%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 22 dias.
• As vagas desta empresa costumam ser preenchidas em 36 dias.
• 16 vagas abertas para uma equipe de 31 pessoas.

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Flagler Health

SiteLinkedInTodas as Vagas

11 - 50 funcionários

Fundada em 2023

🏥 Saúde

🤖 Inteligência Artificial

⚕️ Seguro de Saúde

Healthcare • Artificial Intelligence • Healthcare Insurance

A Flagler Health é uma empresa inovadora de tecnologia de saúde que capacita os provedores de saúde ao aproveitar a inteligência artificial para aprimorar as operações clínicas e administrativas. Suas soluções de IA, como o Motor de Triagem de IA, agilizam os processos de atendimento ao paciente, melhoram os resultados dos pacientes e garantem um agendamento eficiente. A Flagler Health foca em otimizar a experiência de saúde por meio de insights orientados por dados, gestão de cuidados crônicos e monitoramento remoto, permitindo que os provedores ofereçam um atendimento mais personalizado aos seus pacientes.

Descrição

• Own charge and payment reconciliation for new partner practices • Run monthly claim-level payment analysis and identify unpaid, underpaid, denied, or incorrectly adjusted claims • Lead payer follow-up and denial resolution, including rebills, appeals, coding fixes, and front-end fixes • Oversee accurate and timely claim entry and corrections across multiple EHR and practice management systems • Manage billers and contractors, assign work, set priorities, and track throughput • Run denials and billing team meetings and recurring one-on-ones • Produce monthly productivity reporting, conduct sample-based quality audits, and coach team members • Review claims for ICD-10-CM and CPT coding compliance • Create and maintain diagnosis pairing guides and program-specific coding tip sheets • Write and maintain SOPs for claim entry and billing workflows • Lead billing implementation for new partner practices using RTM, CCM, and PCM services • Serve as billing escalation point for active practices and participate in billing and collections calls • Share denial and underpayment patterns with clinical operations and customer success • Redesign billing processes to improve accuracy and shorten time to collection • Partner with engineering on billing requirements, tool testing, and automation • Improve eligibility checks, benefits verification, and patient enrollment logic

🎯 Requisitos

• 5+ years of hands-on revenue cycle experience in physician practice or ambulatory billing, including A/R follow-up, denial management, and payment reconciliation • 2+ years leading or supervising billers, coders, or a denials team • Working knowledge of CPT and ICD-10-CM coding guidelines, ideally for care management codes (RTM, CCM, PCM) • Experience with Medicare, Medicare Advantage, and commercial payers, including working directly with payer representatives • Experience across multiple EHR and practice management systems • Strong spreadsheet skills, including pivot tables and lookups, for claim-level analysis • Clear written communication; comfortable writing SOPs and presenting findings to clients and leadership • CPC, CPB, or CRCR certification is nice to have • Experience working with engineering teams on billing automation is nice to have • Experience at a growth-stage healthcare services company is nice to have • Authorization to work in the United States or Canada • No current or future visa requirement to continue working in the United States or Canada

🏖️ Benefícios

• Compensation review opportunity after six months • Remote work arrangement • Opportunity to lead and build a scalable billing function

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