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Flagler Health

WebsiteLinkedInAlle Stellen

11 - 50 Mitarbeiter

Gegründet 2023

🤖 Künstliche Intelligenz

⚕️ Krankenversicherung

🧘 Wellness

Artificial Intelligence • Healthcare Insurance • Wellness

Flagler Health ist ein innovatives Gesundheits- technologieunternehmen, das Gesundheitsdienstleister durch den Einsatz künstlicher Intelligenz befähigt, klinische und administrative Abläufe zu verbessern. Ihre KI-Lösungen, wie die AI Triaging Engine, optimieren die Patientenversorgungsprozesse, verbessern die Behandlungsergebnisse und gewährleisten eine effiziente Terminplanung. Flagler Health konzentriert sich darauf, das Gesundheitserlebnis durch datengetriebene Erkenntnisse, das Management chronischer Krankheiten und die Fernüberwachung zu optimieren, um den Anbietern letztendlich zu ermöglichen, ihren Patienten individuellere Versorgung anzubieten.

Beschreibung

• Work directly with the CEO, Head of Business Operations, and Head of Clinical Operations to own dozens of relationships with provider groups, ensuring customer satisfaction and retention. • Serve as the primary point of contact and subject matter expert for all RCM-related questions, issues, and escalations from provider partners. • Onboard new customers, ensuring fast, smooth implementation of Flagler's tech platform and services - including integration touchpoints with in-house staff and third-party billing vendors. • Manage and monitor third-party billing partner relationships on behalf of customers, holding vendors accountable to performance benchmarks and SLAs. • Oversee and advise on front-end RCM operations, including prior authorizations, insurance eligibility verification, and patient benefit checks to minimize claim denials at the source. • Monitor and guide back-end RCM operations, including accounts receivable (AR) work-down, denial management, appeals, and collections follow-up. • Create and present monthly reports to customers demonstrating Flagler's impact on clinical and financial outcomes - critical to the core operations and growth of the business. • Identify revenue leakage and reimbursement gaps across the patient journey and collaborate with customers and billing partners to remediate. • Gather and relay RCM and operational feedback from customers to Flagler leadership to inform product development. • Collaborate with sales and tech teams to ensure a seamless customer journey. • Respond to and resolve ad hoc clinic and patient requests efficiently, enhancing their overall experience.

🎯 Anforderungen

• 7–10 years in RCM leadership or customer-facing revenue operations roles within MSK, orthopedic, or procedural specialties, with hands-on experience managing third-party billing vendors - including performance oversight, SLA enforcement, and escalation resolution. • Deep working knowledge of RCM in procedural specialties (MSK/Ortho/Pain), including front-end and back-end revenue optimization, denial management strategy, and vendor performance oversight. • Expertise designing and implementing RCM technologies to augment practice-specific workflows. • Full-cycle RCM fluency: front-end (prior authorizations, eligibility verification, benefits investigation, pre-certification) through back-end (AR work-down, denial management, appeals, aging bucket strategy, and collections). • Strong working knowledge of coding and billing as it applies to pain management and orthopedics - CPT, ICD-10-CM/PCS, HCPCS Level II, modifier usage (e.g., 25, 59, XU, LT/RT), bundling edits, and global period policies. The ability to diagnose coding-related revenue issues is essential; production coding is not. • Professional coding certification (CPC, CCS, COC or equivalent) and/or a degree in Health Information Management is a plus, as are specialty credentials such as COSC or CASCC. • Ability to translate RCM performance data into executive-level insights and strategic action plans for provider partners. • Comfortable building and interpreting RCM dashboards (days in AR, denial rate, clean claim rate, collection rate) and driving accountability across internal and external stakeholders. • Proven ability to manage complex, multi-stakeholder projects independently, prioritize competing deadlines, and deliver results without hand-holding. • Strong communicator and relationship builder - equally effective presenting monthly performance reports to practice administrators and rolling up your sleeves on a client site visit. • Strong-willed team player who is open to feedback, adapts quickly, and thrives in a fast-paced, startup environment. • Comfortable with Google Drive and/or Microsoft Office. • Familiarity with common EHRs, practice management systems, and clearinghouses.

🏖️ Vorteile

• Adjusted comp - Competitive salary & meaningful equity • Benefits - Unlimited PTO • Fully-distributed culture - We are remote first; live and work where you'd like, with an NYC office for folks who want to work together • Ownership - You'll be our go-to for lots of things • Growth - You will learn a lot, very quickly