The Heal product platform is revolutionizing the healthcare experience by putting patients first. We are the undisputed market leader in doctor house calls, telemedicine and remote patient monitoring -  using technology to make care delivery smart, efficient and highly personal. We obsess about every detail to ensure that we continue to extend our paradigm-shifting lead to deliver convenience, choice and transformative care to each and every one of our patients. 

Make your work matter. Your unique contributions and technical ideas can make a rewarding impact on millions of lives in modernizing the healthcare industry. 

Heal has delivered over 150,000 house calls and driven over $60+ million in healthcare cost savings. We are proud to mention our very wide range of notable investors, including: Paul Jacobs, Jeb Bush, Breyer Capital, IRA Capital, Trans-Pacific Technology Fund, Lionel Richie, and more. Additionally, we have won numerous distinguished awards, including: the Web Marketing Association 2018 MobileWebAward for Best Health Care Mobile Application, Top 50 in Digital Health, Most Tech-Friendly Provider, Fierce Innovation Awards - Healthcare 2017, Global Healthcare Magazine: Top 10 Healthcare CEOs, Top 40 Healthcare Transformers of 2018, Disruptor Daily's Top 25 Influencers Shaping the Future of Healthcare, 10 CEOs transforming healthcare in America', CES Innovation Awards, and more. Heal has over 100 major corporate clients and is covered as an in-network benefit with Aetna, Anthem Blue Cross, Blue Shield of California, CareFirst, Cigna, Health Net, Medicare, and United Healthcare. Heal house calls are available across California, Atlanta, Georgia, and Northern Virginia/D.C.

We are changing lives all around the nation. Great people working towards our mission allows for this progress, which is where you come in. 

The Role

You will report directly to the Head of Product and own the development of Heal’s next generation medical billing system from the ground-up. You will act as the interface between stakeholders in Accounting, Medical Billing and Clinical to gather and synthesize requirements, propose solutions, define tickets, and work directly with Engineering to build   software to automate our medical billing processes. You will have an incredible responsibility owning the definition and product development for the revenue engine powering Heal’s business. You must have prior experience in a sophisticated medical billing environment, processing claims, validations, and bring with you a deep understanding of coding and the role of billers. You must be driven by an exceptionally detail-orientated passion to build systems and processes automated by software. You will work closely with dedicated billing software engineers and will be directly tasked with taking Heal’s billing function to the next level through automation and accurate financial reporting. “Upfront price transparency” is one of Heal’s core values: with Heal, patient’s never get a bill after their appointment. This means our technology does a lot of heavy lifting to ensure we provide real-time cost estimation upfront, as well as accuracy during the claims process at the back-end. In this role, you will own the definition, management and scaling of Heal’s end-to-end billing technology. 

About You

  • Prior experience managing medical billing systems, coding, claims and eligibility software - whether using modern APIs or legacy platforms
  • Keen to document processes billing and claims systems
  • Analytical thinker, excited to automate complex manual processes using software to accurately and efficiently to scale volume 10x
  • Results-driven and passionate about advancing the most patient-friendly billing experience in the healthcare industry
  • Excited to develop products that make a measurable impact on real lives every single day, 365 days a year
  • You must bring with you in-depth knowledge and experience in the following areas:
    • Translating EOB
    • Applying a fee schedule
    • Knowing when a deductible or coinsurance should be applied
    • Knowing when a claim is scrubbed/failed/rejected/paid
    • Knowing where to find codes and what codes to apply based on age/services rendered
    • Knowledge of HCFA forms
    • When a claim needs to be refunded or is billed incorrectly vs coded incorrectly, ie sometimes wrong codes vs sometimes billed wrong insurance
  • Must have an understanding of insurance eligibility
  • Must understand various terms of payment from insurers, ie VBC vs FFS vs HMO Cap
  • Must be versed in CMS billing guidelines for seniors (Medicare and Medicare Advantage)

Responsibilities 

  • Understand and define requirements for payer contracts’ front-end workflow processes, claim cycle, charge capture, follow-up, ERA/EFT, denial workflows, collections processes, reimbursement methodologies, ANSI 5010 file types, billing claim forms, in a multi-payer environment including Commercial, Medicaid and Medicare, and deliver practice reporting requirements, including CPT/HCPCS/NDC codes, Quality Reporting/ CMS Star reporting , and HEDIS
  • Develop, manage and own Heal’s billing product roadmap, including systems to automate, report and manage cost estimations, payment status, and remittance, working with payers, Medicare, and vendors 
  • Own the relationship with eligibility vendors, including troubleshooting and acting as our interface to submit and track support tickets through to their resolution by vendors
  • Development and integration of third-party platforms as needed (e.g. Stripe, ClearingHouse) 
  • Deliver system implementation of Federal and State billing guidelines and best practices
  • Establish a definitive and up-to-date and centralized repository of all existing and new  payer contracts with Business Development, Marketing and Finance, for the purpose of ensuring accuracy in our claims system
  • Capture requirements around Heal’s complex billing logic by working with key stakeholders
  • Work closely with Heal billers to understand current systems, processes and functions in order to understand what to automate and in what order 
  • Define billing products and systems, create tickets in JIRA
  • Work closely with finance, accounting and accounts receivables

What We Need

  • Minimum BA or BSc required in Accounting, Finance, Business, Engineering, or Technology related field
  • At least 5 years experience in a Medical Billing function, , ideally in a technical or technology role, building or managing billing systems
  • Understanding of billing practices and Revenue Cycle fundamentals
  • Prior experience in Project Management, or Product Management role(s)
  • Experience in an Agile development environment or technology-driven environment 
  • Experience writing product requirements in tickets (using JIRA and/or other ticketing systems)
  • Experiencing managing a product roadmap
  • Experience in a prior technology or innovation-driven company a bonus
  • Prior experience healthcare necessary
  • Prior experience documenting billing systems, coding, claims, and remittance processes 
  • Excellent written and verbal communication skills
  • Fluent with Microsoft Office (Word, PowerPoint, Excel) and Google Suite (Docs, Sheets)
  • Fluent in building flow charts, business 
  • Fluent in analytics methodology and tools (e.g. Metabase, Tableau, etc.)
  • Experience with surveys, market research and analysis
  • Exceptional attention to detail

Apply for this Job

* Required

  
  
When autocomplete results are available use up and down arrows to review
+ Add Another Education


U.S. Equal Opportunity Employment Information (Completion is voluntary)

Individuals seeking employment at Heal are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation. You are being given the opportunity to provide the following information in order to help us comply with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements.

Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

Race & Ethnicity Definitions

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.


Form CC-305

OMB Control Number 1250-0005

Expires 05/31/2023

Voluntary Self-Identification of Disability

Why are you being asked to complete this form?

We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

  • Autism
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
  • Blind or low vision
  • Cancer
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or hard of hearing
  • Depression or anxiety
  • Diabetes
  • Epilepsy
  • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome
  • Intellectual disability
  • Missing limbs or partially missing limbs
  • Nervous system condition for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)
  • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression

1Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.