About The Position

We are seeking a talented Program Manager who is familiar with the billing complexities of the healthcare industry. You will have strong analytical skills to ensure we are accurately submitting claims into our billing system. You will find root cause defects that prevent us billing (e.g., local edit errors, missing encounters), and understand and maintain charge management rules. This ties to understanding the downstream impacts for collections. This role will partner closely with RCM Operations, Healthcare Finance Operations, Product, and Tech.

Requirements

  • 3+ years of program or project management experience
  • 3+ years of defining and implementing process improvement initiatives using data and metrics experience
  • Knowledge of Excel (Pivot Tables, VLookUps) at an advanced level and SQL
  • Experience using data and metrics to determine and drive improvements
  • Experience working cross functionally with tech and non-tech teams

Nice To Haves

  • 3+ years of driving end to end delivery, and communicating results to senior leadership experience
  • 3+ years of driving process improvements experience
  • Experience in stakeholder management, dealing with multiple stakeholders at varied levels of the organization
  • Experience building processes, project management, and schedules

Responsibilities

  • Monitor and improve clean claim submission rates by identifying and resolving charge capture defects, including local edit errors and missing encounters
  • Establish and maintain charge management rules to ensure accurate coding, pricing, and billing compliance across all service lines
  • Track key metrics including charge lag, encounter capture rates, and billing accuracy while creating dashboards for performance visibility
  • Partner with RCM Operations, Healthcare Finance Operations, Product, and Tech teams to optimize charge capture workflows and system configurations
  • Oversee provider onboarding and credentialing processes to ensure timely setup in billing systems and prevent billing delays
  • Conduct root cause analysis on billing errors and lead continuous improvement initiatives to reduce manual processes and increase automation
  • Ensure charge capture processes comply with healthcare regulations, payer requirements, and support audit preparation

Benefits

  • health insurance (medical, dental, vision, prescription, Basic Life & AD&D insurance and option for Supplemental life plans, EAP, Mental Health Support, Medical Advice Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage)
  • 401(k) matching
  • paid time off
  • parental leave
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