Director of Revenue Cycle and Payer Strategy
About The Position
At Posterity Health, we are revolutionizing men's healthcare through a digital-first, patient-centric approach. Our mission is to empower individuals with access to specialized care while advancing outcomes in fertility, hormone management, and overall reproductive health. As a startup, we thrive in a fast-paced, dynamic environment where innovation, collaboration, and adaptability drive success. We are seeking a Director of Revenue Cycle and Payer Strategy to lead the development, execution, and optimization of our billing processes and contracting strategies. This role will be pivotal in ensuring efficient revenue cycle management, strengthening payer relationships, and supporting operational excellence. The ideal candidate is a strategic thinker with a strong background in healthcare billing and contracting, who is comfortable navigating the ambiguity and fluidity of a startup environment.
Requirements
- Bachelor's degree in Business Administration, Healthcare Administration, or a related field (MBA or MHA preferred).
- Minimum of 5 years of experience in healthcare billing, revenue cycle management, or payer contracting.
- Strong knowledge of billing systems, payer-provider relations, and healthcare regulations.
- Working knowledge of case rate methodologies and experience billing, tracking and reconciling associated payments.
- Excellent negotiation, communication, and relationship-building skills.
- Proven ability to analyze data, develop actionable insights, and implement solutions.
- Comfortable working in a startup environment, handling ambiguity, and adapting to rapid change.
Nice To Haves
- Fertility experience strongly preferred.
- Experience with Athena EMR required.
Responsibilities
- Oversee timely claims submission and payment reconciliation in collaboration with internal teams, monitoring claim submission turnaround, payment posting accuracy, and overall revenue capture.
- Track and analyze key performance indicators such as denial rates, days in Accounts Receivable, clean claim rate, and rework rate
- Identify gaps and implement corrective actions to optimize revenue cycle performance.
- Lead collaboration with payers to resolve escalated issues, streamline processes, and ensure compliance with contract terms, reimbursement policies, and regulatory requirements.
- Drive operational efficiency by implementing process improvements, leveraging technology tools, and guiding staff to achieve RCM performance goals.
- Design and implement robust billing processes to optimize revenue capture and reduce denials.
- Analyze and improve existing workflows for efficiency and accuracy.
- Collaborate with the Operations team to align billing strategies with broader business objectives.
- Negotiate and manage payer contracts, ensuring favorable terms for Posterity Health.
- Evaluate and renegotiate existing contracts to align with organizational goals and market trends.
- Maintain a database of contracts and track compliance requirements.
- Oversee provider credentialing and enrollment with commercial payers.
- Ensure timely submission and re-credentialing to maintain network participation.
- Oversee collaboration with clinical and operations teams to ensure required documentation is collected and maintained.
- Monitor compliance with payer-specific credentialing requirements and regulatory standards.
- Serve as a liaison between operations, clinical, and finance teams to align billing strategies with organizational priorities.
- Provide insights and reporting to leadership on billing and contracting performance.
- Ensure adherence to all federal, state, and local regulations related to billing and contracting.
- Stay informed about industry trends and regulatory changes affecting billing and reimbursement.
Benefits
- Be part of an innovative, growing startup shaping the future of reproductive healthcare.
- Collaborate with a passionate team dedicated to transforming patient experiences and outcomes.
- Opportunity to make a significant impact in a dynamic, fast-paced environment.
- Work with cutting-edge technology and play a key role in advancing healthcare innovation.
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What This Job Offers
Job Type
Full-time
Career Level
Director
