Revenue Operations Associate

WHO WE ARE

The Role:

Responsibilities:

• Independently own Revenue Cycle initiatives from inception through execution, building comprehensive project plans and working with cross functional stakeholders as needed
• Build scalable billing practices from pre-submission to post-submission with the ultimate goal of accelerating cash collections
• Project manage parts of the entire Revenue Cycle function in regards to setting up new payment structures as Sword Health expands product offerings
• Identify and implement areas of improvement in Sword’s revenue cycle, while also developing documentation for how to achieve these
• Examples: Claims submission Rejection troubleshooting, Denials and A/R management, accelerated cash collections
• Work cross-functionally with the Product team to introduce more automation in our claim and invoice billing processes
• Work closely with the engineers to test new billing tool features and further automate end-to-end revenue cycle processes
• Collaborate with the Data / Analytics team to build reporting related to RCM KPIs.
• Report out on key revenue cycle metrics (e.g. denial rate, write-off percentage, charge lag and time to cash) and identify ways to improve these moving forward
• Own the end-to-end new client billing lifecycle which includes participating in external calls with clients, payers, health plans; representing Sword as the reimbursement SME
• Confidently explain Sword’s reimbursement model and work with external partners to obtain any necessary information for accurate and timely collections
• Collaborate cross-functionally with Commercial and Legal teams to ensure we are able to bill our new clients, and escalate any reimbursement issues as needed
• Train and educate any new RCM team members on best practices and industry benchmarks related to digital health reimbursement

Requirements:

• At least 1.5 - 2 years of experience in healthcare provider revenue cycle, preferably in a consulting or analytics role
• Working knowledge of industry best practices in RCM processes: billing, charge capture, contractual adjustments, third-party reimbursements, and cash collections Experience working cross-functionally with different teams and project managing internal projects with multiple competing stakeholders
• Attention to detail and comfort independently solving problems
• Efficient written and verbal communication skills
• Advanced Excel skills
• Persistence when working and communicating with insurance payers
• Fundamental knowledge of revenue integrity (i.e. CPT and ICD-10 coding) Comfortable working with the ambiguity of a fast-paced startup
• Degree in healthcare management, accounting, finance or business preferred, but not required