Revenue Cycle Manager

Job Description

Job Description

Tia is on a mission to transform healthcare for women by increasing access to and improving the experience of key preventive healthcare services. Known as the best and only way to both transform outcomes and reduce cost, Tia's preventive care model focuses on integrating key services across primary care, mental health, gynecology, dermatology and other wellness services. Tia is trailblazing a new paradigm for women's healthcare that treats women as whole people vs. parts or life stages. Blending in-person and virtual care services, Tia's "Whole Woman, Whole Life" care model is a unique and "life-long" model for women's care. By making women's health higher quality and lower cost, Tia makes women healthier, providers happier, and the business of care delivery stronger — setting a new standard of care for women everywhere.

Role Title : Revenue Cycle Manager

Role Summary :

This role oversees the entire credentialing process at Tia as well as the back end of the revenue cycle process specifically from the time that we receive a rejection, denial, or remit from the payer through to payment posting. This role will lead a team to ensure that our providers are effectively tracked through the process of credentialing and enrollment and work closely with our market partners to ensure that our contracts are set up correctly. In this the role will be responsible for ensuring repeatable and optimal systems and operating procedures are in place for both the processes for enrolling a provider, setting up contracts, and also identifying when there is something wrong and troubleshooting to figure out what is going wrong. In addition this role will be responsible for leading a team on the backend billing and revenue cycle function. To clearly create policies, and delineate between areas of responsibility between internal operations and the operations of our patient accounting system vendor. In doing so this role will ensure that claims are being paid quickly and accurately at expected rates and identifying when there are issues and diagnosing the issues. This position will create key performance metrics and make sense to ensure the team is operating at a level that is consistent with the excellence we are pursuing as an organization.

Key responsibilities :

• Team Leadership

Lead a team of credentialing specialist & billing leads providing guidance, coaching, and direction on collaborative and high-performance culture in the function.

Establish and monitor key performance indicators (KPIs) to measure the effectiveness and efficiency of the billing & credentialing team. Analyze performance metrics and implement initiatives to achieve and exceed organizational targets.

Identify and resolve potential areas of revenue leakage within the revenue cycle. Utilize a strategic and data-driven approach to analyze financial processes, proactively identifying gaps and implementing targeted solutions. Collaborate with cross-functional teams to ensure the seamless integration of initiatives.

Lead a dedicated team focused on minimizing rejections and denials by implementing robust operations for claims submission and validation. Develop and implement measures to address rejections, reduce denials, and optimize the claims process to maximize reimbursements. Utilize reporting and analytics to identify patterns and implement actionable solutions.

Establish a process to identify underpayments, review payment discrepancies, and work with stakeholders to ensure that all payments align with contractual agreements and fee schedules.

Ensure accurate and timely recording of payments, specifically virtual credit cards and checks from our lockbox system are being recording in our patient accounting system and in our data.

Oversee the enrollment process for Electronic Data Interchange (EDI) and Electronic Funds Transfer (EFT) with payers. Develop and maintain strong relationships with market partners & payers to facilitate smooth enrollment processes.

Lead a dedicated credentialing and enrollment team to ensure timely and accurate provider credentialing with various payers. Implement best practices to streamline the enrollment process, reducing delays and ensuring uninterrupted revenue streams. Stay current on industry regulations and payer requirements to maintain compliance throughout the credentialing lifecycle.

Develop and maintain effective relationships with market partners, and payers. Collaborate with cross-functional teams to address payer-related challenges.

Competencies :

The salary range is $90,000 - $118,000

Benefits

About Us :

Founded in 2017 by Carolyn Witte and Felicity Yost, Tia is the modern medical home for women. We are trailblazing a new paradigm for women's healthcare that treats women as whole people vs. parts or life stages. Blending in-person and virtual care services, Tia's "Whole Woman, Whole Life" care model fuses gynecology, primary care, mental health and evidence-based wellness services to treat women comprehensively. By making women's health higher quality and lower cost, Tia makes women healthier, providers happier, and the business of care delivery stronger — setting a new standard of care for women everywhere.

Tia has raised more than $132 Million in venture capital funding to date, including a recent $100 Million Series B investment, one of the largest early-stage rounds ever for a healthcare company focused on women. Tia has ambitious plans to scale its "whole-woman, whole-life" model to more than 100,000 women by 2023. We'll do this by growing virtual and in-person operations in existing and new markets while expanding its service lines to care for women throughout their entire lives from puberty to menopause. Since launching in 2017, Tia has grown to serve thousands of women aged 18-80 with blended in-person and virtual care in New York City, Los Angeles, Phoenix and soon San Francisco.

We're building a world class team to reimagine women's healthcare. We're an interdisciplinary team of clinicians, researchers, designers, technologists and operators who have seen firsthand how broken the healthcare system is for women. We're united by a powerful mission to enable every woman to achieve optimal health, as defined by herself, as well as a shared set of values and principles that define our business, products, and culture.

Tia is building a culture of excellence — in people, process and product. This is our northstar value;

What is excellence, exactly?

Excellence about constantly elevating yourself, it is the process of constantly striving to perform to the best of your abilities, and identifying your top potential through constant learning, experimentation and evolution. Excellence is not about achieving perfection, as that insinuates a pinnacle. Instead, in our terms, excellence is about the pursuit of constant improvement. We're looking for people who want to go on that hard journey of constantly setting new personal records, and organizational records.

We practice excellence at Tia by demonstrating the following types of behaviors : We chose (and actively choose) excellence as Tia's highest order value because it crystalizes into one word several behaviors that we hold dear, specifically :

A drive to constantly improve through experimentation, reflection. and an insatiable growth mindset — said another way, we're energized by the possibility of invention, innovation, and iteration

Being present in and grateful for the journey — not just the goal line. Perfection is static. Excellence is a process (more on this important distinction below)

Asking why, then why again — because accepting "this is just the way it is" is not good enough

Grit & perseverance — a maker mentality that involves "rolling up your sleeves", but also deep care for oneself and for others

A commitment to uncovering talents to unlock "rock star" potential across every individual

Furthermore, excellence reflects the "bigness" and the "boldness" of Tia's mission and vision — a world in which every woman can achieve optimal health, as defined by herself.

Said another way, Tia's mission is NOT to make healthcare incrementally better for women. Instead, we've intentionally set out to create a fundamentally new paradigm for modern women's healthcare that's truly excellent. We believe that creating a company that operates in a culture of excellence will manifest in our product. Reaching this goal is not an overnight pursuit or a "one and done." We have not and will not "get it right" with the first swing. Rather, this higher order goal is a moving target — one we have not and will not ever fully "achieve." By design, we will never be "done" with this work, but instead, we will be continuously in pursuit of our mission. It is this continuous pursuit — the journey, not the finish line — that truly embodies excellence.

Tia is an equal opportunity employer. We are proud to foster a workplace free from discrimination. We strongly believe that diversity of experience, perspectives, and background will lead to a better environment for our employees and a better product for our users and patients. We strongly encourage people of color and members of the LGBTQ+ community to apply.

If you are committed to collaborative problem solving, creating high-quality and user-centric products, and want to make waves in women's healthcare, join us!