Director Of Revenue Operations

About Enara

Enara is a world-renowned obesity and medical weight loss start-up, based in Silicon Valley, pioneering the use of data, digital, and clinical treatments to provide personalized plans with measurable results. Enara was founded by people from Stanford, UCSF, Kaiser, ClassPass & Evernote. Our mission is to develop the first ever platform to scale obesity treatment. Our platform allows for the latest breakthroughs in nutrition, exercise, and obesity science to be optimized and delivered in a series of personalized and programmable experiences. Our solutions are disseminated through unified products and services we deploy for the healthcare ecosystem; with a current focus on small to medium sized medical groups and clinics. Our platform has served over 2000 members and delivers world leading 16%+ weight loss sustained over 3 years and is covered by a majority of insurance plans! We are backed by Offline.VC, Charge.VC, VSC, Continuum Ventures, as well as many prominent angels in Silicon Valley.

Role:

The Director of Revenue Operations is responsible for developing and managing Enara’s revenue cycle operations overseeing insurance eligibility, reimbursement, compliance, and membership strategies. The director will lead all teams in the areas of eligibility, coding, billing, account receivable, and systems across all our medical groups and partners. The director will work closely with our partnership team and physician offices to promote optimum member relationships and seamless revenue cycle operations.

Key Responsibilities

• Develop and monitor performance dashboards with Key Performance Indicators across clinics
• Drive insurance-related special projects, including remote patient monitoring. RPM Billing and assist with payer contracting
• Possess an in -depth understanding of Medicare physician payment process and commercial/third party payer regulations
• A/R management, collections, and reconciliation
• Oversee the implementation of Nextgen and RCxRules to drive coding, billing, and reporting automation.
• Maintain reimbursement related key performance indicators for practices, setting and benchmarking revenue cycle goals (i.e. reducing Days in A/R, decreasing outstanding Performances receivable, increasing first pass rate)
• Developing and documenting revenue cycle policies and procedures, monitoring performance reports to improve practice financial position, and coaching and developing employees
• Develop and maintain an overlaying membership strategy to drive improved member experience while driving a consistent member revenue cycle.
• Collaborate with other team leads, including Clinical Operations, Provider, Product/Engineering, as needed for best practice insurance billing
• Develop and implement best practices for insurance billing to maximize reimbursement, including monitoring changing regulations and adapting accordingly
• Ensures adequate staffing for the department; evaluates quality of performance of department staff (both onshore, offshore, and outsourced)
• Establishes workflows to manage and continuously improve the company’s enterprise revenue cycle across multiple physician groups.

Minimum Qualifications

• 1-2 year experience running or building a healthcare membership or concierge revenue cycle.
• Five or more years of healthcare experience in revenue/accounts receivable financial analysis, claims/billing analysis, decision support, or economics
• In-depth knowledge of net revenue, patient accounting and accounts receivable management
• Knowledge of clinical operations, billing, and coding
• Understanding of contractual allowance, bad debt, and financial statement reserve process
• Bachelor's degree in accounting, business, finance, economics, mathematics, or related field
• You have 1-3 year experience with systems and operation that manage billing for several TINs and medical groups.
• Proficiency in compiling, assessing and trending AR key metrics
• Knowledge of third-party payer regulations and contracts
• Familiarity with CPT, HCPCS, ICD-10 coding, revenue codes, and hospital billing/claims processing
• Exceptional financial analysis, communication, organizational, problem solving, and documentation skills

Bonus Qualifications (Nice to have's)

• Proficiency with NextGen and RcX Rules
• 1+ years of experience in Merit-Based Incentive Payment System (MIPS) reporting.
• Proficiency with claims splitting at clearing house level.

Position Specifics

• Equity package.
• 401k, Medical, Dental, Vision.
• Full-time
• Competitive compensation 105-150k.

401k, Medical, Dental, Vision.

Competitive compensation 105-150k.

Equity package.