Revenue Cycle Operations Manager

The lack of diversity in mental health care makes it difficult for young adults and People of Color to find the empathetic treatment they need to live happier and healthier lives.
ReKlame Health aims to remedy this problem by offering underserved populations the opportunity to work with a young, culturally diverse team of mental health clinicians dedicated to providing accessible and affordable treatment to BIPOC communities and other underrepresented groups.
ReKlame Health is looking to partner with more payers to offer affordable and accessible mental health care to patients. As our Billing and Revenue Operations Manager, you will be instrumental in establishing and optimizing our insurance, billing, and revenue cycle functions to support our growth and serve more patients in new and existing markets (commercial and Medicaid). This role requires a detail-oriented individual who thrives in a fast-paced startup environment and enjoys developing innovative solutions to streamline processes. Join our team and make a meaningful impact in improving patients' mental health outcomes.
What You'll Do

• Operate as the in-house expert on insurance billing, building out documentation and training for the full team to train up on best practice billing processes.
• Maintain follow-up systems for tracking and reporting of claims and denials.
• Manage, establish KPIs and track Revenue Cycle process.
• Manage invoicing, reimbursements and reconciliation processes.
• Support new payor partnerships, working collaboratively with internal and external stakeholders to ensure we have the pieces in place to offer covered care to more patients.
• Create new systems and policies to support claims processing, billing, coding, and denials.
• Ensure a smooth, efficient, and timely claim submission process with minimal denials, including identifying gaps in claims.
• Counsel patients regarding financial and insurance related questions, including Medicaid enrollment.
• Review revenue and reimbursement issues and design continuous process improvement interventions to positively impact net revenue.
• Support patients paying with insurance through intake, onboarding, and payment collection.

Who You Are

• Strong passion for advancing equitable healthcare, with a deep-rooted ability to empathize with ReKlame patients.
• Experience with revenue cycle management software, accounting software and financial operations, including strong understanding of payers, grants, coding issues, fee and collection policies.
• Familiar with the healthcare industry's regulations, billing practices, and payer requirements, including knowledge of CPT codes, ICD-10 codes, and HIPAA regulations.
• Nimble, ability to move quickly, ability to handle multiple tasks.
• Experience working in healthcare financial management, particularly in revenue cycle management. This includes experience in billing, coding, collections, reimbursement, and denial management.
• Strong understanding of CPT codes, modifiers, and Dx codes as they relate to psychiatry and behavioral health.
• Certifications: Professional certifications, such as Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Executive (CRCE), or Certified Healthcare Financial Professional (CHFP), can demonstrate the candidate's expertise in revenue cycle management and healthcare finance.
• Able to exercise initiative and excited to build new processes.
• Team player with proven ability to develop strong working relationships within a fast-paced startup environment.
• Experience leading and managing teams, setting goals and performance metrics, and fostering a positive work environment.
• Experience working with claims reporting and patient eligibility verification.
• Experience working with Medicaid and commercial fee-for-service revenue models.
• Professional Biller Certification (AAPC CPB) preferred, but not required.
• 3-5 years professional experience, preferably in healthcare billing or revenue cycle management
• Problem solver who is self-motivated and able to work independently.
• Exemplify strong attention to detail.
• Thrives in an unstructured and resource-constrained environment, with a strong inclination towards problem-solving and self-guided learning.
• A bachelor's degree in finance, accounting, business administration, or a related field is required.
• Strong analytical and problem-solving skills are crucial for identifying inefficiencies in the revenue cycle process, resolving billing discrepancies, and optimizing cash flow.
• Excellent communication and interpersonal skills are required to effectively collaborate with internal teams, such as billing specialists and clinical staff, and external stakeholders, such as insurance companies and regulatory agencies.
• Proficiency in using revenue cycle management software, electronic health records (EHR) systems, and other financial management tools is essential. The candidate should also be comfortable working with Microsoft Office applications, particularly Excel.

We offer a full benefits package and much more!
ReKlame Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.