Sidecar Health is redefining health insurance. Our mission is to make excellent healthcare affordable and attainable for everyone. We know that to accomplish this lofty mission, we need driven people who will make things happen.
The passionate people who make up Sidecar Health’s team come from all over, with backgrounds as tech leaders, policy makers, healthcare professionals, and beyond. And they all have one thing in common—the desire to fix a broken system and make it more personalized, affordable, and transparent.
If you want to use your talents to transform healthcare in the United States, come join us!
About the Role
In this role, you will be the go-to expert on facility claim reimbursements, particularly focusing on APC payments. You'll design and enhance procedures for managing insurance payments, including gap analysis and process refinement. You'll lead a specialized team processing claims, contribute expertise to interdisciplinary initiatives, guarantee quality by reviewing processed claims, and formulate strategies for effective insurance-related facility claims management.
What You'll Do
- Serve as a subject matter expert on facility claim reimbursements, especially regarding APC payments
- Develop processes to handle insurance payments for facility claims (i.e. gap analysis, process improvement)
- Oversee a dedicated team of processors handling claims
- Collaborate in cross-functional projects; contributing your expertise to the provider engagement team and technical squads by formulating processes and software for facility claims management
- Review facility claims processed by the team to ensure that quality standards are consistently met
- Devise strategies for managing facility claims related to insurance payouts
What You'll Bring
- 5+ years of experience in handling facility claims, including proficiency in APC and DRG payment methodologies, preferably in a hospital or insurance carrier environment
- Robust knowledge of APC reimbursement methodologies
- Comprehensive knowledge of facility claims processing, including proficiency in ICD-10-CM, ICD-10-PCS, CPT-4 & HCPCS, DRG, and APC codes
- Proven experience in designing processes and mentoring team members
- Expertise in root cause analysis and improving operational processes
- Proven track record managing a team in a fast-paced environment, with a particular focus on meeting quality and productivity objectives
- An innovative problem-solving approach, with the capacity to make informed decisions in the face of ambiguous information
- Familiarity with coding/billing prerequisites, government regulations, and compliance requirements concerning hospital and professional reimbursement
- Bachelor's Degree
What You'll Get
- Competitive salary, bonus opportunity, and equity package
- Comprehensive Medical, Dental, and Vision benefits
- A 401k retirement plan
- Paid vacation and company holidays
- Opportunity to make an impact at a rapidly growing mission-driven company transforming healthcare in the U.S.
Sidecar Health is an Equal Opportunity employer committed to building a diverse team. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.