Circadia Technologies Ltd
Head of Medical Billing
Circadia Technologies Ltd, Los Angeles, California, United States, 90079
Company Overview:Circadia Health is a medical device and data technology company that has developed the world's first FDA cleared contactless remote patient monitoring system. Powered by cutting-edge technology and AI, the system allows for the early detection of medical events such as Congestive Heart Failure, COPD Exacerbations, Pneumonia, Sepsis, UTIs, and Falls. We're monitoring over 20,000+ lives daily and growing rapidly. As we scale our team, Circadia is looking for energetic, personable, and solutions-oriented individuals driven by creating the ultimate customer experience. Prior experience in healthcare is a big plus, but not required. Our mission is to enhance patient outcomes and improve healthcare processes by providing cutting-edge solutions to healthcare providers and patients alike.Position Description:We are seeking a dynamic and experienced Head of Medical Billing to oversee our comprehensive billing operations, focusing on Medicare and Medicare Advantage billing for Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM). This leadership role will ensure compliance with all federal and state regulations, streamline our billing processes, and optimize revenue cycle performance. This is a pivotal role for a growth-stage medical technology company utilizing a MSO-PC model, and you will be instrumental in ensuring the financial integrity and operational efficiency of the revenue cycle process.This position demands a deep passion for improving patient care through healthcare technology and a hands-on approach to solving challenges. Your ultimate goal will be to deliver an exceptional customer experience while building the foundation for Circadia's future success.Revenue Cycle Oversight:
Manage end-to-end revenue cycle processes, specifically Medicare and Medicare Advantage billing for RPM and RTM. Ensure compliance with federal and state regulations, particularly related to Medicare billing. Lead the development and implementation of standardized billing, coding, and reimbursement practices across the company.Billing & Contracting Expertise:
Lead the setup of contracting with payers, ensuring optimal terms for the organization. Oversee the negotiation and relationships with Medicare Administrative Contractors (MACs) to ensure seamless claims processing and payment.Denials Management:
Develop strategies to reduce denials, improve collections, and manage accounts receivable. Oversee denials management teams to maximize revenue recovery and minimize losses.Team Leadership & Development:
Build, scale, and manage onshore and offshore teams that handle revenue cycle operations, billing, and claims management. Foster a high-performing, collaborative culture within the revenue cycle teams, ensuring that all members are aligned with company objectives.Off-Shoring Strategy & Execution:
Lead the design and execution of off-shoring strategies to increase efficiency and reduce operational costs. Set up offshore teams with proper training and performance monitoring to maintain high-quality standards.Payer Relations & Contracting:
Establish and maintain payer contracts to ensure the organization is well-positioned for revenue maximization. Lead efforts in payer contracting and compliance, ensuring all agreements align with company growth and regulatory requirements.Metrics & Reporting:
Utilize KPIs and performance metrics to track revenue cycle efficiency, identifying areas for improvement. Ensure timely and accurate reporting to executive leadership on all key revenue cycle indicators.Qualifications:Bachelor’s degree in Health Administration, Business, or a related field; advanced degree preferred5+ years experience in medical billing and revenue cycle management, particularly with Medicare and Medicare Advantage populations.Strong knowledge of medical billing regulations and compliance requirements.Benefits:Full healthcare coverage with Anthem BCBS (or similar) with dental and vision or reimbursement towards an existing planWellness programs, such as gym membership reimbursement or access to virtual fitness classes up to $100 per monthMental health resources, such as access to counseling or meditation apps such as Headspace or CalmContribution to 401(k) retirement planPhone plan reimbursement of up to $75 per monthPaid Time Off (PTO) accrual policy of 1.7 working days per monthWeek off between Christmas and New Year’s, discretionary based on the manager’s approval
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Manage end-to-end revenue cycle processes, specifically Medicare and Medicare Advantage billing for RPM and RTM. Ensure compliance with federal and state regulations, particularly related to Medicare billing. Lead the development and implementation of standardized billing, coding, and reimbursement practices across the company.Billing & Contracting Expertise:
Lead the setup of contracting with payers, ensuring optimal terms for the organization. Oversee the negotiation and relationships with Medicare Administrative Contractors (MACs) to ensure seamless claims processing and payment.Denials Management:
Develop strategies to reduce denials, improve collections, and manage accounts receivable. Oversee denials management teams to maximize revenue recovery and minimize losses.Team Leadership & Development:
Build, scale, and manage onshore and offshore teams that handle revenue cycle operations, billing, and claims management. Foster a high-performing, collaborative culture within the revenue cycle teams, ensuring that all members are aligned with company objectives.Off-Shoring Strategy & Execution:
Lead the design and execution of off-shoring strategies to increase efficiency and reduce operational costs. Set up offshore teams with proper training and performance monitoring to maintain high-quality standards.Payer Relations & Contracting:
Establish and maintain payer contracts to ensure the organization is well-positioned for revenue maximization. Lead efforts in payer contracting and compliance, ensuring all agreements align with company growth and regulatory requirements.Metrics & Reporting:
Utilize KPIs and performance metrics to track revenue cycle efficiency, identifying areas for improvement. Ensure timely and accurate reporting to executive leadership on all key revenue cycle indicators.Qualifications:Bachelor’s degree in Health Administration, Business, or a related field; advanced degree preferred5+ years experience in medical billing and revenue cycle management, particularly with Medicare and Medicare Advantage populations.Strong knowledge of medical billing regulations and compliance requirements.Benefits:Full healthcare coverage with Anthem BCBS (or similar) with dental and vision or reimbursement towards an existing planWellness programs, such as gym membership reimbursement or access to virtual fitness classes up to $100 per monthMental health resources, such as access to counseling or meditation apps such as Headspace or CalmContribution to 401(k) retirement planPhone plan reimbursement of up to $75 per monthPaid Time Off (PTO) accrual policy of 1.7 working days per monthWeek off between Christmas and New Year’s, discretionary based on the manager’s approval
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