About Us:

At Ginger, we believe that everyone deserves access to incredible mental healthcare. Our on-demand system brings together behavioral health coaches, therapists, and psychiatrists, who work as a team to deliver personalized care, right through your smartphone. The Ginger app provides members with access to the support they need within seconds, 24/7, 365 days a year. Millions of people have access to Ginger through leading employers, health plans, and our network of partners.

Ginger has been recognized by The World Economic Forum as a Technology Pioneer and by Fast Company as one of the Most Innovative Companies in Healthcare.

About the role:

We are looking for someone who has a background in healthcare provider revenue cycle - specifically, understands the mechanics/complexity of medical claims billing and financial health KPI reporting. This individual will be willing to roll up their sleeves and own the day to day revenue cycle management responsibilities, enjoys working cross-functionally to automate and improve every detail of our revenue cycle and is able to report on the financial stability of our business to our leadership team. We are looking for someone who can wear multiple hats, is a self-starter and is passionate about improving the financial health of our business. Finance and accounting experience is a plus, but not required.

Responsibilities:

• Partner with the Engineering, Product, and Operations teams to continue to introduce automation to our claims billing processes and to build & scale fee for service opportunities.
• Continuously work to identify areas of improvement and develop processes and documentation in the Company’s revenue cycle.
• Develops Revenue Cycle-specific policies in regards to: payer follow-up, appeals, write-offs, rejected claims etc.
• Build out reporting for revenue cycle KPIs,including claim denial rates, claim write-offs, charge lag, time to cash, etc.
• Manages new client and partner enrollments in order to submit claims, monitoring initial claim processing, automating submission and reporting to leadership on the reimbursement of specific accounts.
• Owns the entire life-cycle of billing for a new client from taking part in external calls with clients, payer integration, health plans, partners and representing Ginger as the Revenue Cycle subject matter expert.
• Own end to end claims revenue cycle transformation projects including Documentation and coding (optimizing codes we are currently billing, expertise in FFS billing and telehealth codes)
  • Claims submission and management
  • Denials and A/R management
  • Collections and payment posting
  • Reporting and metrics
• Project manages the entire Revenue Cycle function, setting up new payment structures as we expand our program offerings.
• Implement a new revenue cycle management system and manage RCM vendor.
• Communicates cross-functionally with the Sales and Customer Success teams on
  upcoming customer deals/launches that require claims billing & ensuring that customer requirements are being fulfilled and escalating any claims issues that arise with specific accounts.
• Acts as the intermediary between the Commercial team and the product and engineering teams for any billing and reimbursement-specific requirements and troubleshooting claim issues.
• Train and educate team members on RCM best practices and industry benchmarks to improve Revenue Cycle metrics and build team accountability around following up on unpaid claims with carriers on a regular cadence.

Requirements:

• At least 7 years of experience in healthcare provider revenue cycle
• Advanced Excel skills
• Persistence when working/communicating with payers
• Experience working cross-functionally with different teams
• Experience project managing internal projects
• Working knowledge of industry best practices in Revenue Cycle processes: billing, charge capture, contractual adjustments, third-party reimbursements, and collections and cash management
• Fundamental knowledge of revenue integrity (i.e. CPT and ICD-10 coding) and documentation requirements for billing and compliance
• Knowledge of payor policies, payor plans and processes related to coding and claims billing
• Expertise with fee for service billing/coding & telehealth coding/billing.
• Comfortable working with the ambiguity of a fast-paced startup
• Efficient written and verbal communication skills
• Attention to detail, exceptional organizational and problem-solving skills
• Degree in accounting, finance or business preferred, but not required