Billing Operations Manager

Company: Cadence Solutions
Location: New York
Posted on: October 18, 2024

Job Description:

The Cadence Solutions team seeks a Billing Operations Manager to join our Growth Operations Team. As a Billing Operations Manager at Cadence, you will be responsible for ensuring the accuracy and compliance of all billing operations. Your role will involve auditing billing practices to ensure that all bills align with data, enabling accurate billing for our health system partners. You will also work closely with finance, product, and technology teams to validate insurance plans, manage patient copayments expectations with our health systems, and support the expansion into commercial insurance and additional billing codes.
WHAT YOU'LL DO:Billing Operations Management:

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• Oversee the daily operations of the billing department, ensuring accurate and timely processing of invoices.
  
• Validate insurance plans and ensure that patient coverage and copayments are accurately calculated and communicated to our Partners, as well as validate that patient eligibility is aligned with insurance coverage for RPM.
  
• Develop and implement standardized billing procedures to maintain consistency and compliance across the organization.
  
  Auditing and Data Alignment:
  
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  • Conduct regular audits of billing operations to ensure that all bills align accurately with data collected, facilitating precise billing for health system partners.
    
  • Identify discrepancies between billed amounts and data, and work with relevant teams to resolve any issues.
    
  • Implement best practices for billing audits to continuously improve the accuracy and reliability of billing processes.
    
    Expansion into Commercial Insurance and Billing Codes:
    
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    • Support the company's expansion into commercial insurance markets by developing and implementing processes for new billing codes and procedures aligned to successful billing and retention of patients with these payor plans.
      
    • Work closely with the Product and Technology teams to integrate new billing codes into the EMR system and ensure accurate coding and documentation.
      
    • Monitor the performance of commercial insurance billing and identify opportunities for optimization and growth.
      
      Collaboration with Finance, Product, and Technology Teams:
      
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      • Partner with the finance team to ensure that billing operations align with financial goals and reporting requirements.
        
      • Collaborate with the Product team to identify and implement automation solutions that streamline billing processes and enhance efficiency.
        
      • Work closely with the Technology team to ensure seamless integration of billing systems with EMR and other operational tools, addressing any technical issues that arise.
        
        Compliance and Regulatory Adherence:
        
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        • Ensure all billing practices comply with federal, state, and local healthcare regulations, including Medicare, Medicaid, and commercial insurance guidelines.
          
        • Stay updated on changes in healthcare billing regulations and update company policies and procedures accordingly.
          
          Process Improvement and Automation:
          
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          • Identify opportunities to streamline billing operations, reduce errors, and enhance efficiency.
            
          • Partner with the Product and Technology teams to develop and implement automation tools and technologies for billing processes.
            
          • Continuously monitor and analyze billing data to identify trends and make data-driven decisions for process improvements.
            
            Stakeholder Collaboration:
            
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            • Collaborate with finance, operations, and compliance teams to ensure alignment of billing operations with overall company objectives.
              
            • Communicate effectively with external partners, including insurance companies and healthcare providers, to resolve billing issues.
              
            • Provide regular reports and updates to senior management on billing operations, compliance status, and key performance indicators.
              
              WHAT YOU'LL NEED:Qualifications:
              
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              • Bachelor's degree in Business, Healthcare Administration, Finance, or a related field.
                
              • 5+ years of experience in billing operations, preferably in the health tech or healthcare industry.
                
              • Strong understanding of healthcare billing regulations, including Medicare, Medicaid, and commercial insurance guidelines (experience with RPM, CCM, APCM, and care management billing a plus).
                
              • Experience with auditing billing practices and ensuring alignment between bills and data.
                
              • Proven experience in managing billing teams and optimizing billing processes.
                
              • Excellent leadership, communication, and organizational skills.
                
              • Proficiency in billing software, EMR systems, and other relevant operational tools.
                
              • Ability to work remotely and manage a distributed team effectively.
                
                Preferred Skills:
                
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                • Experience with process automation and data analysis.
                  
                • Knowledge of healthcare compliance and quality assurance practices.
                  
                • Familiarity with Telehealth, RPM technologies, and digital health platforms.
                  
                • Strong problem-solving skills and a strategic mindset.
                  
                  WHO WE ARE:The work we do at Cadence each day changes lives and as such, the stakes and the pace are high. Our fully remote work environment values autonomy, curiosity, and experimentation. Our team is challenged with new opportunities daily. We are growing fast and want team members who are excited about tackling an endless list of big and complex problems. Cadence has rapidly grown into one of the largest remote patient monitoring platforms in the US, and we are just getting started.
                  We seek ambitious individuals who are passionate about lifelong learning and eager to be part of a winning team that's shaping the future of healthcare. In return, we provide competitive total compensation packages with meaningful equity in one of the fastest growing healthtech companies in the US. If you're ready to make a difference and drive positive change, we invite you to join us at Cadence.
                  WHAT YOU'LL GET:Cadence recognizes the unique needs of its diverse, distributed workforce and seeks to provide an inclusive work environment for its world-class clinicians and technologists.
                  
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                  • Company culture all about impact, shared growth mindset, empowerment, and integrity
                    
                  • An opportunity to help improve the quality of life of millions of Americans
                    
                  • Medical, dental, and vision insurance
                    
                  • Competitive salaries and stock options
                    
                  • TelaDoc (virtual primary care), and TalkSpace (online mental health services) memberships
                    
                  • Discounted ClassPass memberships
                    
                  • Unlimited PTO and paid holidays
                    
                  • Remote equipment setup and home office stipend
                    
                  • Paid Parental Leave
                    
                  • Charitable Donation Match program
                    
                  • Expected compensation range: $90,000 - $100,000 annually
                    
                  • Location: Remote
                    
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Keywords: Cadence Solutions, Fairfield , Billing Operations Manager, Executive , New York, Connecticut