Revenue Cycle Manager

USA | Care Team | Full-time | Allows remote

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About Boulder Care

 

Boulder Care is a telehealth provider offering treatment and long-term support for people with substance use disorders.

Opioid overdose is the leading cause of death for Americans under 50, but fewer than 10% of people who need treatment are receiving it. Boulder is closing this gap by providing high-quality medication-based treatment via a digital platform. Patients get the support they deserve from our world-class care teams from anywhere that is convenient and comfortable. 

 

Why work at Boulder?

 

  • Make a difference. Medication-assisted treatment works, but in the midst of a national crisis, the majority of US communities have no access to it. By providing more people with quality care, we can save and transform lives.
  • Work with the best. Boulder brings together the best clinicians, technologists, researchers, and business strategists, with the common goal of expanding access to life-saving treatment. Boulder’s clinical teams are the leading voices in addiction medicine. Our technology leadership has built products and services that scaled to hundreds of employees and hundreds of millions of end-users.
  • Grow with us. Boulder is a Series A stage, venture-funded company with investors like First Round and Greycroft Partners, and the opportunity to build a massive business. Our healthcare systems spend billions combating the opioid epidemic. By offering better care, we save lives and save payors money, creating immense financial value.

 

Revenue Cycle Manager at Boulder Care

 

As a digital care provider, Boulder Care contracts with private and governmental health insurers and other enterprise clients to make addiction treatment more accessible and affordable for people across the US.

We are hiring a Revenue Cycle Manager to support our provider group's innovative value-based payment strategies, ensure adequate insurance coverage and reimbursement for Boulder's services, and to help quantify the return on investment to payor customers.

Reporting initially to the Chief Operating Officer, the Revenue Cycle Manager will operationalize end-to-end contracting, billing & collections processes during a period of rapid company growth. For an executive excited about innovation in healthcare, this role offers a chance to contribute to company-building strategy in areas of business development, managed care contracting, and product development, with high visibility into the rest of Boulder’s operations.

 

Responsibilities

    Operationalize Revenue Function 

  • Design, implement and operationalize Boulder Care’s end-to-end revenue cycle management function 
  • Ensure success and accuracy of medical claims workflow pre and post adjudication
  • Understand and resolve medical claim challenges, while guiding the company towards scalable solutions that enhance the participant experience and enable the growth of our business 
  • Be the subject matter expert for all revenue cycle questions, including participating in cross-functional efforts to increase efficiency of systems and processes related to this vertical
  • Work with the company’s executive team to support and allocate roles and responsibilities for financial operations cross-functionally, partnering with Finance, Operations, Product, Business Development and Contracting teams
  • Help hire, develop and lead individuals responsible for Billing (including Medical Claims), Eligibility and Cash Collections claims 
  • Optimize accounts payable and accounts receivable
  • Make recommendations to improve revenue capture such that Care Team members can focus exclusively on providing excellent care and delivering exceptional, compassionate patient experience
  • Inform decisions about what is done in-house versus with a vendor/outsourced billing team
  • Vet, implement, and oversee external accounting and finance vendors
  • Identify opportunities to improve, automate, streamline, and implement Finance processes, optimizing operations and technology 
  • Represent Boulder in discussions with payors across the customer life cycle, spanning initial contracting & implementation to maintenance & electronic data exchange. 
  • Help assess and onboard new customers’ claim billing requirements 
  • Monitor and implement best practices necessary for a healthy revenue cycle
  • Work closely with external vendors and systems that influence the success of our payor integrations. 

    Financial Reporting & Analysis

  • Support the company's monthly revenue accounting and reporting, in accordance with U.S. GAAP or other accounting standards and company policies
  • Support the month-end close process, which includes reviewing journal entries, revenue accruals, and account reconciliations
  • Work with external auditors to assist in annual audits and quarterly reviews
  • Ensure that revenue recognition is communicated, implemented, and applied consistently
  • Develop profitability analysis for clinical service lines and payor classes

    Support Partnerships with Health Insurers and Enterprise Clients

  • Design, substantiate and implement a cohesive revenue strategy that achieves Boulder’s business objectives, including supporting significant near-term growth through partnerships diverse health plan and employer customers in multiple states
  • Analyze and help inform customer contracts
  • Prepare technical memos to summarize revenue issues relevant to major contracts, and provide appropriate conclusions and recommendations  
  • Drive the technical application of revenue recognition, including advising on managed care contracting structure, contract language, accounting consequences and reporting outputs

Requirements

  • 3+ years of relevant revenue cycle experience and 5+ years in related financial services preferred
  • Knowledge and experience in Medical Claims billings (including Medicare/Medicaid)
  • Understanding of insurance plan benefit design
  • Dedication to driving efficiencies and process automation, building lightweight infrastructure to support a growing startup
  • Ability to consistently comb through large amounts of data and draw insights from it
  • Capable of presenting complex claims billing workflow information in an easy to understand format
  • Diplomacy to navigate requests and requirements from diverse payors and systems to serve customers without compromising receipt of revenue or requiring extensive administrative overhead
  • Solid written and verbal communication skills, with the ability to communicate technical accounting requirements to a non-technical audience
  • Comfort making decisions in ambiguous situations and doing things for the first time
  • Ability to proactively identify and escalate problems and offer persuasive resolutions
  • A passion for teamwork, collaboration, and the ability to partner with and influence cross-functional personnel
  • Analytical self-starter with strong business judgment
  • Excellent project management skills with sharp attention to detail.

You might be a great fit for this role if you have

  • Built similar infrastructure at a comparable healthtech or tech-enabled healthcare services company
  • Experience managing financial data in a HIPAA-compliant environment
  • Deep experience in the innerworkings of healthcare payors and benefits plans, with a strong desire to make systems work better for patients and caregivers.

 

Boulder Care is an equal opportunity employer that recruits, employs, trains, compensates and promotes regardless of race, religion, color, national origin, sex, disability, age, veteran status, and other protected status as required by applicable law. If you believe in our mission to deliver the world’s most advanced opioid addiction recovery plan, you are encouraged to apply.