Revenue Cycle Manager
Omada Health is on a mission to inspire and enable people everywhere to live free of chronic disease. We’re seeking a revenue cycle manager to execute and improve Omada’s revenue cycle management (RCM) function. The manager will be expected to understand Omada’s RCM framework, and work with the RCM team in developing effective methods and tools to drive cash collections. Omada wants to leverage your professionalism, experience, and expertise to think strategically on how we can improve our revenue cycle platform. This includes not only performing day-to-day tasks, but coming up with strategies on how to scale revenue cycle practices in an efficient and effective way. Because of the complex nature of healthcare billing, we are seeking professionals who have the necessary skill sets to grow the business unit.
The manager will work with internal and external stakeholders to ensure all aspects of claims billing and collection processes are in place to support our mission. Your work will ensure that Omada recovers its claims in a timely fashion, our payers are impressed with our service, and our members can focus on improving their health. This position will be at the forefront of defining the company’s processes, best practices, and systems to further support Omada’s financial growth.
- Design and implement RCM processes and systems to minimize claim denial rate and bad debt rate, and to improve cash flow and ensure industry standard clean claim submission rate
- Responsible for RCM operations and management, including the achievement of Accounts Receivable and Bad Debt Reserve goals in order to achieve department and company goals
- Educate customers and internal stakeholders on how to integrate with Omada’s unique billing model
- Ensure claims and billing generation is completed accurately and timely and reconciles with Accounting records
- Be the go-to person at Omada for revenue cycle questions, including participating in cross-functional efforts to increase efficiency and effectiveness of systems and processes related to the revenue cycle
- Ensure all policies, procedures and initiatives are handled in compliance with HIPAA privacy and security regulations
- Process and systems implementation
- Execute the monthly claim generation process and address exceptions
- Strategize on methods to improve all functions of RCM including insurance verification, billing, etc.
- Collaborate with Omada’s clearinghouse on all issues related to claims management
- Assist with any new system implementations related to the RCM platform
- RCM operations
- Perform monthly bank and claim reconciliation
- Complete monthly revenue integrity checks
- Oversee and manage billing practices. This includes ensuring claims are not approaching timely filing or appeal windows.
- Investigate, document, and work with finance to execute refunds
- Investigate, document, and take action on denials and/or underpayments
- Ensure account receivables remains accurate and transparent
- Be the main point person for revenue cycle related questions
- Documentation, training, and ongoing communication
- Educate customers and internal stakeholders on how to integrate with Omada’s revenue cycle platform
- Mentor and develop RCM framework for additional members if needed
- Create documentation around RCM practices at Omada
Strong candidates for this position will have the following:
- 5+ years of experience with revenue cycle systems
- Experience executing revenue cycle management, especially in a healthcare setting
- Knowledge of industry terminology and best practices
- Proficiency in Excel a must
- Proficient about basic accounting and business management knowledge as it relates to revenue cycle
- Knowledge of the US healthcare system, digital health, and the startup work environment
- Passion for Omada’s mission
- Ability to develop fantastic relationships with both internal and external stakeholders
- A passion and ability to deliver quality work that meets or exceeds expectations
- Excellent written, verbal, and presentation communication skills
- Demonstrate the ability to thrive in a fast-paced environment with minimal oversight. Flexibility, resilience, and adaptability are key attributes
- Ability to handle repetitive tasks, and continue to find ways to make processes more efficient
- Ability to balance day-to-day execution with long-term priorities
- Ability to engage with all levels of an organization and different types of teams (executive, technical, finance, product, etc.)
About Omada Health: Omada Health is a digital care provider that empowers people to achieve their health goals through sustainable behavioral change. Working with health plans, employers, and health systems, the company delivers personalized interventions for individuals dealing with chronic conditions, musculoskeletal issues, anxiety, and depression. Combining data-powered human coaching, connected devices, and curriculums tailored to an individual’s specific conditions and circumstances, Omada has enrolled more than 450,000 participants across all 50 states. Omada’s partners include major employers across the country, including Costco and Iron Mountain, as well as leading health plans, such as Cigna and Kaiser.
We carefully hire the best talent we can find, which means actively seeking diversity of beliefs, backgrounds, education, and ways of thinking. We strive to build an inclusive culture where differences are celebrated and leveraged to inform better design and business decisions. Omada is proud to be an equal opportunity workplace and affirmative action employer. We are committed to equal opportunity regardless of race, color, religion, sex, gender identity, national origin, ancestry, citizenship, age, physical or mental disability, legally protected medical condition, family care status, military or veteran status, marital status, domestic partner status, sexual orientation, or any other basis protected by local, state, or federal laws.