Revenue Cycle Analyst

Role Description

Omada Health is seeking a Revenue Cycle Analyst to execute, document, and continuously improve Omada’s Revenue Cycle Management (RCM) function. The Analyst will be expected to understand Omada’s RCM framework and work with the RCM team in developing effective methods and tools to process data and drive cash collections. You will work directly with both internal and external stakeholders to ensure robust billing and efficient collection processes are in place to support our mission.

Your work will ensure that Omada recovers its claims in a timely fashion, our payers are impressed with our service, and our participants can focus on improving their health. This position will be at the forefront of refining the company’s processes and practices to further Omada’s financial growth.

Your impact:

• Process and Systems Implementation
  • Assist team on a smooth end-to-end billing process
  • Assist with any new RCM payer implementations
  • Assist with communication to Omada’s clearinghouse on new connections and any claims management issues
  • Participate in cross-functional efforts to increase efficiency and effectiveness of RCM systems and processes
  • Identify and propose enhancements to workflows based on data, trends, and user feedback
  • Support testing, validation, and rollout of new or updated RCM processes to ensure accuracy and compliance
• Documentation, training, and ongoing communication
  • Work with payers to integrate with Omada’s unique billing model and educate internal stakeholders
  • Maintain clear, up-to-date process documentation and standard operating procedures (SOPs) for RCM workflows
  • Ensure all policies, procedures and initiatives are handled in a HIPAA-compliant fashion
  • Respond to operational questions across email, Slack, and ticketing tools
  • Ensure cross-functional teams have the support they need to complete requests
• RCM Operations
  • Investigate, document, and follow up on denials and underpayments
  • Investigate, document, and execute refunds
  • Assist with achieving team Accounts Receivable and Bad Debt Reserve goals
  • Perform weekly bank and claim reconciliation
  • Complete monthly revenue integrity checks
  • Complete recurring work queues on a monthly basis

Qualifications

• Passion for Omada’s mission
• 1 - 3 years’ experience executing revenue cycle management in a healthcare setting
• Knowledge of the US healthcare system, industry terminology (e.g. CPT and ICD-10 diagnosis codes), and best practices
• Advanced proficiency in Excel
• Excellent written and verbal communication skills and comfort working with both technical and non-technical stakeholders
• Ability to juggle both proactive scheduled tasks along with reactive escalations

Bonus points for:

• Experience working with or for a healthcare clearinghouse
• Understanding of Accounting principles
• Knowledge of digital health and/or a startup work environment
• Experience in SQL or Tableau

Benefits

• Competitive salary with generous annual cash bonus
• Remote first work from home culture
• Flexible Time Off to help you rest, recharge, and connect with loved ones
• Generous parental leave
• Health, dental, and vision insurance (and above market employer contributions)
• 401k retirement savings plan
• Lifestyle Spending Account (LSA)
• Mental Health Support Solutions
• ...and more!