Senior Associate, Revenue Management

Company: Oak Street Health
Location: Chicago
Posted on: April 10, 2021

Job Description:

Title: Senior Associate, Revenue Management Location: Treehouse Oak Street Health is a rapidly growing, innovative company of community-based healthcare centers delivering higher quality health and wellness care that improves outcomes, manages medical costs and provides an unmatched experience for adults on Medicare in medically underserved communities. By providing holistic, comprehensive and integrated care right in our patients' communities, we can help keep them healthy and reinvest cost savings in further care for those same communities and others. Since 2013, Oak Street Health has brought its singular approach to tens of thousands of people across the nation. With an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody Oak Street values and are passionate about our mission to rebuild healthcare as it should be. For more information, visit www.oakstreethealth.com. Role Description: The Senior Associate of Revenue Management is responsible for strategic leadership on comprehensive HCC billing capture for the organization.-- As a value based organization, Oak Street Health reimbursement is determined by the CMS risk adjustment model based on the diagnoses (HCCs) submitted for its patient population. Clean eligibility and clean claim processing are necessary to ensure all diagnoses are captured for risk adjustment and payment. The Senior Associate of Revenue Management is responsible for optimizing eligibility and claim processing in partnership with Revenue Cycle to ensure 100% of claims are received by the appropriate payers and 100% of HCCs are accounted for. Core Responsibilities:-- The key responsibilities of this role are as follows: Work cross-functionally to execute and optimize processes for eligibility, clean claim processing, and claims reconciliation Maintain the organizational knowledge base related to RAPS/EDS and claims processing Maintain communication channels for relevant stakeholders throughout the organization on progress and areas of opportunity across revenue management and participate in payer conversations-- Key success metrics: HCC Chase: Ensure 100% HCCs documented are on RAPS or MOR and work with payer partners to resolve discrepancies Eligibility: streamline eligibility processes and create visibility on opportunity and progress to achieve 99+% visits billed with accurate insurance and 100% visits with eligibility issues addressed prior to billing Clean Claims : Collaborate on comprehensive OSH billing standards across all programs (in-person visits, home visits, pharmacy, behavioral health, etc.) Claim Corrections : Manage ongoing quarterly process for claim corrections to support compliance Denial Management : Create visibility into denials management and inform prioritization of denials reworking to support organizational objectives Payer Communication : Establish relationships of trust with payer partners on claims processing, supplemental feed, and RAPS/EDS chase efforts Supplemental Feed : Ensure all supplemental feeds are in accordance with payer and CMS specifications Other duties, as assigned What we're looking for This is an exciting opportunity to build a primary business function at a rapidly growing healthcare organization. We're looking for motivated professionals with:-- Demonstrated strategic and analytical problem-solving capabilities, including experience with modeling / forecasting (e.g., consulting / private equity or equivalent) Proficiency in Excel required; familiarity with programming languages, specifically SQL, and/or Tableau or Alteryx preferred-- Experience working in the Medicare risk adjustment space, and experience/exposure to revenue cycle operations-- Ability to make high-level strategic decisions, while also maintaining close attention to detail Ability to function in an entrepreneurial environment and manage in the midst of ambiguity Experience problem-solving, making decisions and delivering impact in a fast-paced environment ("scrappiness") Proven ability to work cross-functionally to drive initiatives forward Someone who embodies being "Oaky" What does being "Oaky" look like? Assuming good intentions Creating an unmatched patient experience Driving clinical excellence Taking ownership and delivering results Why Oak Street?
Oak Street Health offers our coworkers the opportunity to be at the forefront of a revolution in healthcare, as well as: Collaborative and energetic culture Fast-paced and innovative environment Competitive benefits including paid vacation and sick time, generous 401K match with immediate vesting, and health benefits Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply to oakstreethealth.com/careers. You have been redirected to a Oak Street Health job page

Keywords: Oak Street Health, Chicago , Senior Associate, Revenue Management, Executive , Chicago, Illinois