Revenue Cycle Manager
About Cayaba Care
Cayaba Care is a community-based, maternity program that provides wrap-around support throughout pregnancy and postpartum to improve maternal health outcomes. Our multidisciplinary team is led by Maternity Navigators (MNs), who are community health workers and certified doulas, working closely with our members to ensure they have the care they need for a joyful and healthy maternal journey.
Our Values:
- Healthcare is Human: We partner with the communities we serve to address the unique needs of our patients and support whole-person care.
- Pursue Excellence: We earn & build trust with our patients, partners, & each other by striving for excellence without compromising our standards.
- Uplift: We elevate and center underrepresented voices.
- Embrace Innovation: We are creative & resourceful in getting things done.
- Together, not alone: Moving maternal healthcare forward is a shared responsibility that we all care deeply about.
To learn more about Cayaba Care, please visit www.cayabacare.com.
Why You Should Join Our Team
A career at Cayaba Care is an opportunity to work towards addressing our country’s maternal and fetal health crisis. Our team is working together to help improve health outcomes in underserved populations. Opportunities for advancement with increasing administrative or management opportunities. At Cayaba Care, we are focused on building a company where individuals from all backgrounds have the opportunity to succeed and contribute to our mission. Competitive compensation and benefits.
Position Description
The Revenue Cycle Manager (RCM) will be responsible for owning all aspects of the revenue cycle process, from eligibility verification and billing to claims processing and reimbursement. The RCM will ensure that all billing and coding procedures are accurate and up to date. This role will report to the Financial Controller.
Responsibilities
- Work collaboratively with the finance/accounting and care operations team to optimize revenue performance, minimize denials, and ensure timely reimbursement for services rendered
- Manage the revenue cycle process, including insurance verification, coding, billing, authorization management, collections and reporting
- Create and implement policies and guidelines to ensure accurate and timely billing and reimbursement
- Monitor key performance indicators and financial metrics to identify trends, issues, and opportunities for improvement
- Analyze and report on revenue cycle performance to the Financial Controller and Director of Care Operations to identify areas for growth and optimization
- Work closely with the Cayaba Care team to resolve billing discrepancies, denials, and other revenue cycle issues
- Stay up-to-date with healthcare regulations and payor policies to ensure compliance and maximize reimbursement
Qualifications
- Bachelor's degree in accounting, business administration, or a related healthcare field
- 4-6 years of experience in healthcare revenue cycle management, specifically in PemPM (Capitation)
- Computer, analytical, and organizational skills
- An understanding of payor guidelines as well as technical knowledge of the ICD-10 and CPT classification systems
- Familiarity with electronic health record (EHR) systems and revenue cycle management software
- Excellent analytical skills and attention to detail
- Strong communication skills and interpersonal skills with the ability to collaborate with cross-functional teams.
Additional, nice to haves:
- Previous experience in reproductive, women’s and maternal health
- 2-3 years of experience with Athena
Apply for this job
*
indicates a required field