*This is a remote position*
Today, 1 in 3 Americans say they suffer from mental health problems like anxiety, depression, or insomnia. Despite this mental health epidemic, seeing a psychiatrist can take up to 3 months and cost as much as $500.
Shocked? Us too. That's why we started Cerebral, a telemedicine-first mental health startup. We are breaking down the barriers to access mental healthcare so that anybody can get the care and meds they need immediately and for just $85/month. We launched publicly in January 2020 and are growing at over 40% month-over-month. We need your help to continue serving our communities.
Cerebral is seeking a Head of Revenue Cycle Management to provide leadership for all revenue cycle related activities. We are looking for someone who has a background in healthcare revenue cycle and understands the mechanics/complexity of medical claims billing and financial health KPI reporting. This individual will be willing to roll up their sleeves and own the day to day revenue cycle management responsibilities, enjoys working cross-functionally to automate and improve every detail of our revenue cycle and is able to report on the financial stability of our business to our leadership team. You will focus on managing the core processes of accounts receivable, including collections, revenue recognition, EDI, and practice management systems administration. Effective leadership will encompass overseeing the day to day operations of your team while ensuring that core processes increase efficiency, maintain internal service level agreements and meet the goals of Cerebral. We are looking for someone who can wear multiple hats, is a self-starter and is passionate about improving the financial health of our business.
How you will contribute:
- Develops Revenue Cycle-specific policies in regards to: payer follow-up, appeals, write-offs, rejected claims etc.
- Hands-on coding within our clinical model
- Implement the revenue cycle management system and manage RCM vendors
- Can determine and roll out a structure / frequency of visits within INI to optimize for reimbursement revenue
- Build out reporting for revenue cycle KPIs,including claim denial rates, claim write-offs, charge lag, time to cash, etc.
- Project manages the entire Revenue Cycle function, setting up new payment structures as we expand our program offerings
- Owns the entire life-cycle of billing for a new client from taking part in external calls with clients, payer integration, health plans, partners and representing Cerebral as the Revenue Cycle subject matter expert
- Manages new client and partner enrollments in order to submit claims, monitoring initial claim processing, automating submission and reporting to leadership on the reimbursement of specific accounts
- Communicates cross-functionally with the Sales and Customer Success teams on upcoming customer deals/launches that require claims billing & ensuring that customer requirements are being fulfilled and escalating any claims issues that arise with specific accounts
- Partner with the Engineering, Product and Operations teams to continue to introduce automation to our claims billing processes and to build & scale fee for service opportunities
- Acts as the intermediary between the Commercial team and the product and engineering teams for any billing and reimbursement-specific requirements and troubleshooting claim issues.
- Train and educate team members on RCM best practices and industry benchmarks to improve Revenue Cycle metrics and build team accountability around following up on unpaid claims with carriers on a regular cadence
- Monthly revenue recognition and management of monthly close and reporting
- Determining areas of opportunity with current processes to increase collectability and reduce bad debt
- EDI and payment system set up with streamlined output
- Setting and meeting KPIs within the AR function, and executing strategic initiatives based upon business need
- Develop and monitor performance management tools to monitor daily throughput
- Implementation of internal controls and processes to support growth at scale
- Cultivating a culture of compassion, empathy and approachability within the team
- Supporting the team’s career goals and development through consistent feedback, training, and coaching
- Own end to end claims revenue cycle transformation projects including:
- Documentation and coding (optimizing codes we are currently billing, expertise in FFS billing and telehealth codes)
- Continuously work to identify areas of improvement and develop processes and documentation in the Company’s revenue cycle
Skills you’ll bring:
- You have 6+ years of experience in revenue cycle management within healthcare
- A foundation of established professional healthcare relationships in the market and a strong understanding of the local market healthcare landscape and competitive dynamics
- Working knowledge of industry best practices in Revenue Cycle processes: billing, charge capture, contractual adjustments, third-party reimbursements, and collections and cash management
- Fundamental knowledge of revenue integrity (i.e. CPT and ICD-10 coding) and documentation requirements for billing and compliance
- Knowledge of payor policies, payor plans and processes related to coding and claims billing
- Expertise with fee for service billing/coding & telehealth coding/billing.
- Experience working cross-functionally with different teams
- Experience project managing internal projects
- Comfortable working with the ambiguity of a fast-paced startup
- Efficient written and verbal communication skills
- Attention to detail, exceptional organizational and problem-solving skills
- Experience contracting with providers and hospital systems
- Strong presentation and communication skills; ability to consult as well as negotiate
- Strong analytical skills including root cause analysis
- Skilled at collaborating and working across a complex matrixed organization
- Management experience managing large, dispersed, highly skilled professional teams
- Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues
- A Bachelor's degree or equivalent experience required (degree in accounting, finance or business preferred); a Master's degree preferred.
- You never hesitate to roll up your sleeves, but also demonstrate a passion for people management.
- You lead with a clear sense of ownership and transparency, while maintaining accountability and prioritizing professional development.
- You guide teams in their work, while actively removing barriers to success, through a lens of continuous improvement.
- You are passionate about the bottom line, and are driven to meet and exceed goals, are solutions-oriented and adept at determining the root cause to drive outcomes.
- Top-quality healthcare, dental, and vision plans
- Remote friendly (only remote!)
- Monthly happy hours
- Unlimited PTO policy