Revenue Cycle Manager
Omada Health is on a mission to inspire & enable people everywhere to live free of chronic disease. Were seeking a revenue cycle manager to execute & improve Omadas revenue cycle management (RCM) function. The manager will be expected to understand Omadas RCM framework, & work with the RCM team in developing effective methods & tools to drive cash collections. Omada wants to leverage your professionalism, experience, & 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 & 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 & external stakeholders to ensure all aspects of claims billing & 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, & our members can focus on improving their health. This position will be at the forefront of defining the companys processes, best practices, & systems to further support Omadas financial growth.
- Design & implement RCM processes & systems to minimize claim denial rate & bad debt rate, & to improve cash flow & ensure industry standard clean claim submission rate
- Responsible for RCM operations & management, including the achievement of Accounts Receivable & Bad Debt Reserve goals in order to achieve department & company goals
- Educate customers & internal stakeholders on how to integrate with Omadas unique billing model
- Ensure claims & billing generation is completed accurately & timely & reconciles with Accounting records
- Be the go-to person at Omada for revenue cycle questions, including participating in cross-functional efforts to increase efficiency & effectiveness of systems & processes related to the revenue cycle
- Ensure all policies, procedures & initiatives are handled in compliance with HIPAA privacy & security regulations
- Process & systems implementation
- Execute the monthly claim generation process & address exceptions
- Strategize on methods to improve all functions of RCM including insurance verification, billing, etc.
- Collaborate with Omadas clearinghouse on all issues related to claims management
- Assist with any new system implementations related to the RCM platform
- RCM operations
- Perform monthly bank & claim reconciliation
- Complete monthly revenue integrity checks
- Oversee & manage billing practices. This includes ensuring claims are not approaching timely filing or appeal windows.
- Investigate, document, & work with finance to execute refunds
- Investigate, document, & take action on denials and/or underpayments
- Ensure account receivables remains accurate & transparent
- Be the main point person for revenue cycle related questions
- Documentation, training, & ongoing communication
- Educate customers & internal stakeholders on how to integrate with Omadas revenue cycle platform
- Mentor & 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 & best practices
- Proficiency in Excel a must
- Proficient about basic accounting & business management knowledge as it relates to revenue cycle
- Knowledge of the US healthcare system, digital health, & the startup work environment
- Passion for Omadas mission
- Ability to develop fantastic relationships with both internal & external stakeholders
- A passion & ability to deliver quality work that meets or exceeds expectations
- Excellent written, verbal, & presentation communication skills
- Demonstrate the ability to thrive in a fast-paced environment with minimal oversight. Flexibility, resilience, & adaptability are key attributes
- Ability to handle repetitive tasks, & 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 & 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, & health systems, the company delivers personalized interventions for individuals dealing with chronic conditions, musculoskeletal issues, anxiety, & depression. Combining data-powered human coaching, connected devices, & curriculums tailored to an individuals specific conditions & circumstances, Omada has enrolled more than 450,000 participants across all 50 states. Omadas partners include major employers across the country, including Costco & Iron Mountain, as well as leading health plans, such as Cigna & Kaiser.
We carefully hire the best talent we can find, which means actively seeking diversity of beliefs, backgrounds, education, & ways of thinking. We strive to build an inclusive culture where differences are celebrated & leveraged to inform better design & business decisions. Omada is proud to be an equal opportunity workplace & 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.