ZoomCare Careers

Description

• Represent our values: Awesome, Creative, Respectful, Team Players, Get it Done.
• Lead the development of vision, strategy and tactics that optimize revenue cycle performance in the current fee-for-service model and in the developing value based payment program; metrics of success include collections yield, first pass yield, denial rate and days in accounts receivable.  Assess and respond to current and future internal and external healthcare trends to optimize the revenue cycle and overall business performance.
• Works with leaders to maximize teamwork and results across the revenue cycle including patient intake, scheduling, benefits verification, authorizations, billing , coding, collections and reimbursement.

• Develop and maintain cascading dashboards of key performance indicators (KPIs) to track efficiency in claims submission, denial management, and collections with transparency across the organization’s leadership team.

• Ensure that all revenue cycle activities comply with federal, state, and payer-specific regulations, including HIPAA and other healthcare laws.  Establish, document and implement appropriate policies, controls and procedures.   Maintain up-to-date expertise and knowledge of healthcare billing laws, rules, regulations and other developments as necessary to maintain compliance, improve efficiency and inform decisions and strategy.
• Implement and monitor internal controls to safeguard compliance and integrity of revenue cycle processes.

• Collaborate with key stakeholders on cross-functional initiatives targeting RCM improvement opportunities such as claim denials.  Identify and remove root cause issues for sustained improvement. 

• Recruit, train, and mentor revenue cycle professionals, fostering a culture of outstanding customer service and high-performance while developing future leaders across the revenue cycle.
• Collaborate with various stakeholders, such as healthcare providers, insurance companies, and regulatory agencies, to ensure compliance with billing and reimbursement guidelines. 
• Conduct regular performance evaluations providing timely feedback and ensuring alignment with organizational objectives.
• Remain up to date on the latest industry regulations and best practices, and make necessary adjustments to workflows and systems.

• Other duties as assigned.

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field, required, master’s degree in Business Administration, Healthcare Administration, or a related field, preferred.
• 10+ years of progressive experience in healthcare revenue cycle management, with at least 5+ years in a leadership role.
• Extensive experience in ambulatory/provider billing, coding, collections, claims processing, and denial management in a healthcare setting, with at least two years of experience working with Athena, preferred.
• Working knowledge of applicable State and Federal regulatory requirements, including HIPAA, Fraud and Abuse, Medicare, Medicaid, and other payer requirements.

• Deep understanding of healthcare regulations, coding standards (e.g., ICD-10, CPT), and payer-specific guidelines.
• Knowledge of financial planning, budgeting, and forecasting principles as they apply to healthcare revenue management.

• Strong leadership and team management skills, with experience building and developing high-performing teams.
• Effective communication and collaboration skills to work with clinical, financial, and administrative teams.
• Excellent problem-solving abilities and analytical skills, with the capacity to think strategically and manage operational details. 

• Medical, Dental, Vision benefits
• 401K with employer match
• Paid Time Off, Paid Holidays, Paid Parental Leave, Sabbatical Program
• Salary Range: $200k to $250k
• Bonus Eligibility: 25%
• Other Compensation: May be eligible for other compensation such as bonuses or relocation assistance

• Project timelines and work volume/deadlines may often require more than your scheduled hours per week or work outside of regular business hours to complete essential duties of this job.
• Prolonged periods of standing/sitting and working at a computer. 
• A significant portion of this position and those supervised is performed remotely.
• Hybrid/remote work, candidate must reside in Washington or Oregon state.