We are a precision medicine leader, providing evidence-based pharmacogenomic solutions that facilitate more personalized prescriptions across the globe. Our RightMed solution helps healthcare organizations, providers, and payers optimize patient outcomes and reduce costs by facilitating more personalized prescriptions. Paired with an in-house CLIA-certified, CAP-accredited lab, OneOme’s RightMed test provides powerful genetic insights that doctors, pharmacists, and other healthcare providers can use to help inform medication decisions for their patients. Our mission is to provide the most cost-effective, comprehensive, personalized, pharmacogenomics analysis integrated into patients’ everyday clinical care. OneOme was named one of Fast Company’s 50 Most Innovative Companies of 2018.
We are looking for an experienced Revenue Cycle Manager to help lead the company’s revenue cycle processes. The Revenue Cycle Manager will work closely with a third-party billing service as well as the finance, commercial operations, medical affairs, and compliance teams. This individual will strive to maximize revenue in accordance with billing guidelines and minimize accounts receivable.
- Develop payer contracting strategy and facilitates the negotiation of contract terms and rates with health plans and payers
- Work with the finance and business development teams to assess and respond to payment proposals and to develop modeling analysis tools
- Assume responsibility as primary lead for organization in communications to payers for contract negotiations
- Monitor, analyze and report on the state of the payer industry via report cards and other assessments
- Assist with the negotiation and monitoring of contract including the success of meeting financial and quality targets
- Work closely with colleagues to optimize credentialing and billing operations
- Manage processes related to revenue cycle to ensure efficient operation and maximize reimbursement including working with our third-party billing service provider to achieve these goals
- Collaborate with the client services team, taking on administrative and customer service tasks as needed in the billing process
- Report revenue cycle Key Performance Indicator (KPIs) for both internal operations as well as third party performance to management monthly and works to improve metrics to ensure maximum efficiency
- Analyze the revenue cycle data to find opportunities for improvement in collections and claim approvals.
- Coordinate all credentialing, enrollment, and payer contracting efforts nationwide including applications, renewals, and business change information updates for state Medicaid and other payers
- Manage payer relations and coordinating efforts to improve coverage determinations in support of the medical affairs team and Chief Medical Officer
- Other duties and responsibilities may be assigned
- Bachelor’s Degree or 4 years of relevant experience in lieu of a degree is required
- 5+ years of experience in healthcare revenue cycle roles (billing, coding, collections, payer contracting, credentialing, or practice management)
- Knowledge of CPT/HCPCS, ICD-10, fee schedules, claim submission and appeals processes, prior authorization processes, and patient collections processes
- Experience with laboratory and molecular diagnostic billing/coding is preferred
- AAPC or HFMA certification preferred
- Personnel management experience preferred
OneOme Headquarters, 807 Broadway St NE, Suite 100, Minneapolis, MN 55413
Schedule and hours
This position requires the ability to work Monday – Friday during core business hours with occasional evenings or weekends to support requirements for the position.
OSHA RISK FACTOR CATEGORY 1. The employee is regularly required to talk or hear. The employee frequently is required to stand, walk; sit; and use hands to finger, handle, or feel, and work with a computer. The employee is occasionally required to reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; and smell. The employee must occasionally lift up to 50 pounds and/or carry objects weighing up to 25 pounds. The employee is required to perform repetitive motions, including reaching above the head, and typing. Specific vision abilities required by this job include peripheral vision, depth perception, and ability to adjust focus. Color-blindness testing is required for those with job-specific duties requiring color discrimination.
If interested, please send your resume and cover letter to email@example.com.