Revenue Cycle Manager, Tia
$90-118k
+ Stock options
Holistic women's health service
Be an early applicant
Holistic women's health service
201-500 employees
Be an early applicant
$90-118k
+ Stock options
201-500 employees
Company mission
To enable every person to achieve their own definition of optimal health through science-backed information, access to high-quality care, and community.
Role
Who you are
- Leadership and Team Management: The ability to lead a diverse team of talented individuals, access their strengths, weaknesses, & preferences and engage them in the best possible strategy to ensure that they are empowered to succeed as an individual and help the department and organization thrive as a whole
- Dynamic cross functional collaboration: Use of organizational & RCM department historical knowledge context and nuance to engage with the optimal partners to create novel solutions to complex problems
- Lead a healthy culture: Foster a culture within the team of belonging, trust, and accountability that helps to bring out the best out of not only the team but also our cross functional partners
- Process Development & Optimization: Design processes to enhance efficiency, and overall performance. Ability to analyze existing workflows, identify bottlenecks, and implement improvements
- Policy Development: Craft actionable & effective policies that align with organizational and departmental goals. Skilled in conducting thorough research, collaborating with stakeholders, and synthesizing information into clear and actionable policies
- Implementation and Tracking of Operating Procedures: Lead the implementation of new operating procedures. Develop detailed plans, coordinate with cross-functional teams, and provide training to ensure successful adoption. Additionally, skilled in establishing robust tracking mechanisms to monitor procedure effectiveness and identify areas for refinement
- Problem Solving: Tackle complex problems with a systematic and analytical approach. Capable of swiftly identifying root causes and implementing novel solutions. Adaptable problem-solver who thrives in dynamic environments, leveraging a combination of critical thinking, analysis, and collaboration to drive continuous improvement
- Communication and Collaboration: Exceptional communication skills, both verbal and written, with the ability to convey complex ideas in a clear and concise manner. Proficient in fostering collaboration across teams and departments through effective interpersonal communication. Skilled at building relationships, actively listening to diverse perspectives, and facilitating open dialogue to ensure cohesive teamwork and successful project outcomes
What the job involves
- 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
- 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
Our take
Tia is an innovative health-care platform for women. The company was created in response to co-founder Carolyn Witte's experience of waiting three-years for an accurate diagnosis of her PCOS. Essentially, it was formed to help other women have a better experience with doctors and health-care providers.
Tia began as a chat-based, Q&A app and has since evolved into a virtual care service. The company prioritises a personalized and integrative approach, which offers a tailor-made care service. Following 2021 funding, Tia opened clinics across California and Arizona, adding to its New York in-person clinic.
As the company look to grow the number of clinics, it will face multiple challenges. Expansion involves entering the world of commercial real estate, legal and insurance contracts that will challenge the largely app-based company, and it will be necessary to ensure they are able to manage this effectively.
Steph
Company Specialist at Welcome to the Jungle
Insights
-13% employee growth in 12 months
Company
Funding (last 2 of 4 rounds)
Sep 2021
$100m
SERIES B
May 2020
$24.3m
SERIES A
Total funding: $129.3m
Company benefits
- Equal opportunity employer
- Performance-based bonuses
- Work from home opportunities
- We offer every employee health, vision, and dental insurance (with options for dependents, too). And of course — a free Tia membership!
- Unlimited vacation days: we aim to practice what we preach to our patients by encouraging our employees to take time away from work to recharge
- With donation matching programs and community service days, we work to ensure that as a team we’re giving back
Company HQ
SoMa, San Francisco, CA
Leadership
Felicity Yost
(Co-Founder, President & CEO)After studying at Cornell, Felicity worked for over a year as a Management Associate at Bridgewater before spending 2 years as a Product Manager at Owler. In January 2017, she co-founded Tia, serving as COO since then.
Carolyn Witte
(Founding CEO)After studying at Cornell, Carolyn went on to work at Google for 4 years in the Product Marketing team, going on to be Team Lead at Googles Creative Lab.
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