Revenue Cycle Manager

Posted 2.9.24
Location
San Francisco, CA

Who we are:

Midi Health is the only comprehensive virtual care clinic for women in midlife navigating perimenopause, menopause, and other common midlife health challenges. Our platform provides care designed by experts, scaled by technology, and delivered by trained and compassionate clinicians. 

We accept most major PPO insurance products, and we offer convenient access to clinical care through telehealth visits, 24/7 messaging, and responsible prescribing of medications, supplements, and other therapies. 

We’re passionately focused on improving the symptoms of women’s midlife hormone change because the current system too often leaves women misdiagnosed and undertreated. At Midi, we’re changing that.

Where we’re based:

We are an entirely virtual company, so employees can live anywhere

The opportunity:

What we are looking for:  We are seeking an innovative Revenue Cycle Manager to execute and improve our revenue cycle management (RCM) function. The manager will work to develop effective methods and tools to drive cash collections and think strategically about how we can improve our revenue cycle platform.

What this person will be doing: 

As a key member of the Revenue Cycle leadership team, you will report directly to the Head of Revenue Cycle Management. You will be leading a small, but mighty team at the cusp of an exciting growth phase, and will be integral in building the revenue cycle operations that help our patients access the care they need. You will also focus on ensuring that Midi Health patients have a world class billing experience. This position will be at the forefront of defining the company’s processes, best practices, and systems to further support Midi Health’s growth. This leadership position requires a thorough understanding of revenue cycle operations, billing procedures, compliance regulations, and financial analysis.

Responsibilities: 

  • Design and implement RCM processes and systems to improve the revenue cycle and continually reduce days in accounts receivable, increase cash collections, reduce write offs, improve customer service and increase patient satisfaction in support of Midi Health’s projected growth
  • Manages the Billing Supervisor (and the Billing Specialists indirectly) and will own professional development, setting productivity standards, goal-setting, and engagement
  • Oversee all front-end and back-end revenue cycle operations including billing processes, ensuring accurate coding, submission, and follow-up on claims to maximize reimbursement
  • Partner with other internal teams including but not limited to working with the product development team to define and update workflows and tools, working with the clinical team to ensure communication to providers and patients is clear and timely, and working with the business development team to manage onboarding new partners (payors, health systems, and employers)
  • Manage patient communications with respect to complex billing issues, including management of macros in Zendesk and ensuring an excellent patient experience
  • Participate in the monitoring of RCM and Finance KPI’s and execute on action items derived from analysis to ensure Midi remains at best practice levels across all KPI’s
  • Grow our knowledge base repository with process documentation including the development of standard operating procedures and policies 
  • Audit claims to ensure accuracy and proper coding is applied; partner with clinical team to train or retrain providers
  • Respond to commercial payor audits and identify areas of improvement as it relates to coding and documentation 
  • Support tactical planning for new partner launches including employers, custom commercial networks, health systems, clinically integrated networks, billing integrations, and enterprise commercial network agreements
  • Ensures diligent collection of patient financial responsibilities including finding effective and efficient ways to improve the patient billing experience and collection rates 
  • Manage the Athena Correspondence dashboard including Patient Statement Issues (bad addresses) and the Athena Enrollment Worklist 
  • Evaluate and make recommendations for third party tools to enhance revenue cycle operations
  • Act as escalation point for the Billing Supervisor 
  • Act as the coding SME for new services and updates to CPT and ICD10
  • Support external vendor relationships to achieve Midi’s goals and objectives

Qualifications: 

  • 5+ years of revenue cycle and/or healthcare administration experience; telehealth and/or startup experience strongly preferred
  • 2+ years of leading a team 
  • Strong roots in customer service
  • Clinically Integrated Network and/or revenue cycle integration experience preferred
  • Experience implementing patient-friendly price transparency tools 
  • Ability to analyze large amounts of data and draw insights
  • Must have an understanding of electronic claim submission requirements including the use of modifiers, place of service, and taxonomy
  • Strong knowledge of CPT and ICD10 codes as well as HIPAA regulations
  • Experience building a team, including recruiting and hiring new team members, defining new roles and responsibilities and setting performance standards. 
  • Experience working with Athena Collector, preferred
  • Experience partnering with product, engineering, patient experience, operations, and clinical teams in a startup environment 

Who you are: 

You are a problem solver and have a passion for process improvement. Our ideal candidate has a growth mindset and chooses positivity. You will be asked to challenge the status quo and partner cross functionally to solve complex issues. You are a “player/coach” and you never hesitate to roll up your sleeves, but also demonstrate a passion for developing relationships, people management, and leading with a clear sense of ownership and transparency. You hold yourself accountable and prioritize professional development. You have the ability to guide the team through all areas of revenue cycle management, while actively removing barriers to success, through a lens of continuous improvement. As you use your analytical muscle to identify issues or areas of opportunity, you will be expected to present solutions to those issues. 

What we offer:

  • 100% remote opportunity*
  • Competitive compensation aligned with experience
  • Comprehensive health benefits (medical and dental)
  • Competitive PTO Package
  • Paid holidays
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