Director of Revenue Cycle Management

🕒 Agosto 28

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $185.000 - $215.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

👻 Score fantasma 17%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Pair Team

11 - 50 funcionários

💼 Consultoria

📦 Logística

🏥 Saúde

Consulting • Logistics • Healthcare

A Pair Team é dedicada a conectar comunidades carentes com cuidados de alta qualidade. Eles conectam pacientes vulneráveis a equipes locais de cuidados, garantindo acesso a serviços físicos, mentais e sociais. Através de parcerias com organizações comunitárias locais, eles fornecem cuidados integrais à pessoa, coordenação de cuidados e recursos. Sua rede comunitária inclui enfermeiros registrados, clínicos de saúde comportamental e diversos provedores de saúde, com o objetivo de melhorar os resultados e o bem-estar dos membros da comunidade. O foco é dado na construção de confiança e na oferta de uma abordagem holística aos cuidados dos pacientes, reduzindo visitas a salas de emergência e engajando pacientes anteriormente não engajados com provedores de cuidados primários.

Descrição

• Own the RCM function end to end across Medicaid and Medicare, from eligibility and authorization through claims, denials, and collections • Lead RCM strategy, including team building, hiring and managing RCM staff, KPI development and reporting, and cross-functional collaboration • Analyze claims data to identify gaps, drive remediation, and improve collection rate and DSO • Manage patient billing and coinsurance collection processes • Own denial management and appeals, reducing rejection and denial rates • Centralize eligibility verification, authorizations, and payer reporting under RCM • Work directly with payers and provider groups to remediate claims issues and manage payer reporting relationships • Partner with Finance on revenue reconciliation, cash application, and collections reporting • Ensure compliance with Medicaid and Medicare billing requirements • Select, implement, and optimize RCM systems for multi-program billing and growth • Build scalable, automated processes for a fast-moving startup • Report to the VP of Finance and BizOps

🎯 Requisitos

• 8+ years of progressive Revenue Cycle Management (RCM) experience, with end-to-end ownership across eligibility/enrollment, charge capture, coding, claims submission, denials management, and collections • Deep, hands-on knowledge of Medicaid and Medicare billing across the full revenue cycle, ideally including FFS, risk-based arrangements, and other healthcare billing structures • Experience building and leading teams in a high-growth, early-stage startup • Ability to independently query and analyze claims data, generate insights, and drive collection rate improvements • Strong communication and collaboration skills across finance, accounting, operations, product, and engineering • Experience implementing RCM solutions such as Candid, Waystar, etc. • Ownership mindset and ability to drive results • Ability to thrive in a fast-paced, complex, low-red-tape early-stage environment • Passion for serving individuals with complex chronic needs, including homelessness, severe mental illness, and substance use disorder • E-Verify employment eligibility verification for new hires • Passing a pre-employment background check is required

🏖️ Benefícios

• Equity compensation package • Medical, dental & vision with HSA/FSA and company HSA contribution • Remote-first with equipment and $100/mo home office stipend • Flexible PTO and 12 paid holidays • 100% company-paid life, disability & AD&D • Backup childcare, caregiver concierge, and financial guidance resources

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