Billing Manager (Healthcare ) - Livara Health

Billing Manager

The Company 

• CEO: Rob Cohen 
• Investors: A1 Health Ventures, Martin Ventures, Polaris Partners, Providence Ventures
• Website: livarahealth.com

Company Description 

Livara is reimagining musculoskeletal care for value-based provider groups and health plans. With an interdisciplinary, biopsychosocial, and high-touch clinical model, Livara works with payors, risk-bearing providers, and health systems to improve outcomes, reduce costs, and fill gaps in the current musculoskeletal (MSK) care model. 

Livara, created by way of the legacy SpineZone business alongside investments by A1 Health Ventures, Martin Ventures, Polaris Partners, and Providence Ventures, operates a hybrid clinical model. The company’s digital care delivery, care management, and care navigation platform offers online services in 14 states while in-person care is provided through 10 company-owned SpineZone clinic sites in Southern California and partnerships with 3rd party clinics elsewhere. The high touch, multi-service focus allows patients to get the high quality care they need. 

With the MSK space being extremely fragmented and lacking cohesion between Primary Care Physicians, Physical Therapists, and Surgeons, there are many barriers for companies to enter the value-based care world. Livara’s fully integrated pathway brings everything together in one place, creating a seamless experience. The company brings a highly clinical and data-driven approach to MSK care, with a solution focused on 3 main pillars: care planning, care delivery, and care navigation. The system is designed to predict and qualify clinical risk factors to highlight where the biggest impact is going to be. From there, Livara is able to take the continuous flow of data from the patient to the clinician and quickly adjust any treatment course based on these results. 

Livara is pioneering value-based contracts in the MSK space, headed by CEO Rob Cohen and Co-Founder and Chief Medical Officer (CMO) Kamshad Raiszadeh. Unlike most competitors, the company takes on risk and focuses on Medicare and fully insured populations, with key partners that include Elevance, Providence, and Scripps. 

The Role

Livara is seeking a mission-driven Billing Manager to join our innovative team, reporting directly to Seth Maloff, VP of Financial Planning and Analysis. The Billing Manager will be responsible for efficiently managing and leading the Revenue Cycle Management (RCM) billing team. Using knowledge and expertise, the Manager will continually work to enhance the current billing process, provide continuous monitoring and active management of all revenue cycles to maximize collections.  If you are passionate about excellence, thrive in a collaborative environment, and are committed to making a meaningful impact through compassionate and empowering leadership, we’d love to hear from you!

As a Billing Manager at Livara you will:

Oversees the entire billing process within the practice including but not limited to the following:

1. Supervises the day-to-day operations of the billing department by assigning tasks to team members, setting priorities, and monitoring progress to ensure that billing activities are completed efficiently and on time.
2. Establish and maintain billing policies and procedures to ensure consistency and compliance. Develop standardized templates, guidelines, and workflows that streamline billing processes, reduce errors, and improve efficiency.
3. Owns management of the RCM billing system including the creation, maintenance and upkeep of the allowable and fee schedules. Ensure continual integration between the Electronic Medical Record (Clinical) and Practice Management (billing) systems and suggest enhancements for improved workflows.
4. Ensure the accuracy of billing data. Review of claims for errors or discrepancies, conduct audits to identify potential issues, and implement quality control measures to minimize billing errors and improve accuracy.
5. Contribute to timely cash flow management by ensuring timely and accurate claims, patient statements, and payment processing. Continually work to enhance collections, prevent revenue leakage, and optimize reported revenue.
6. Monitor patient collection, track outstanding statements, and implement strategies to expedite collections and reduce accounts receivable.
7. Support RCM Operations in developing and maintaining an infrastructure for timely and accurate submission of claims.
8. Contribute to patient retention efforts by ensuring smooth billing experiences and addressing patient concerns promptly.
9. Play a crucial role in resolving billing discrepancies and addressing patient inquiries or concerns. Oversee the investigation to resolve billing disputes and act as the point of escalation and facilitate resolution. Collaborate with internal teams and patients to gather necessary information, mediate negotiations, and strive for satisfactory resolutions to maintain patient satisfaction and minimize financial losses.
10. Effective collaboration by working closely with Operations, Finance, and Corporate teams to coordinate billing activities, address billing-related inquiries, and ensure alignment between departments for smooth operations.
11. Collaborate with the finance department to provide accurate billing data for financial reporting and analysis. Generate billing reports, analyze key performance indicators, and provide insights that support financial planning.
12. Identify areas for workflow enhancement, implement automation tools and technologies to streamline workflows, and drive efficiency in the billing department.
13. Stay updated with the latest industry trends, best practices, and technological advancements in billing and invoicing. Actively seek opportunities to enhance their knowledge and skills, ensuring the practice remains competitive and up to date with industry standards.
14. Provide ongoing guidance to billing team staff, conduct performance evaluations, constructive feedback and identify areas for improvement. Set performance goals, track progress, and motivate team members to achieve excellence in their roles.
15. Provide ongoing training and education to the staff/relevant stakeholders on billing processes, systems, and policies. Create training materials and conduct training sessions to ensure that billing procedures and compliance requirements are understood.
16. Responsible for communicating billing policies, updates, and changes to relevant stakeholders within the practice. Ensure that all applicable employees are aware of billing procedures, compliance requirements, and any modifications to billing processes.
17. Ensure the availability of accurate records for auditing purposes and provide necessary documentation during internal or external audits.
18. Perform other duties as assigned.

We’d love to talk more if you have:

• Associate degree or equivalent experience required
• 5 years’ work experience in a healthcare environment required
• 1-2 years leading an RCM team, ensuring accurate and efficient coding of patient records in compliance with federal and state regulations and guidelines
• Experience in physical therapy coding preferred
• Demonstrated knowledge of medical terminology
• Must have working knowledge of healthcare regulatory and compliance policy (i.e., HIPAA)
• Experience in project implementation and/or program management
• Advanced Excel skills preferred
• Possess excellent listening and oral communication skills
• Communicate clearly and concisely, both orally and in writing, including the ability to follow a written script, submit comprehensive summary reports and other written materials
• Ability to effectively establish and maintain cooperative and effective working relationships
• Effectively prioritize competing responsibilities, with a sensitivity toward matters which are time sensitive
• Exercise a high level of discretion and sensitivity to patient privacy with the ability to recognize, evaluate, solve problems, and correct errors
• Must be able to adapt to a continually changing environment.
• Organize and maintain extensive records, research and compile information, and have ability to multi-task in a fast-paced environment
• Strong technical aptitude to not only operate standard office equipment but also relevant software such as Excel, G-Suite, EMR & Practice Management systems and other applications.
• Plan, organize, prioritize, and perform duties in accordance with department policy and procedure as assigned with minimal supervision
• Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner.
• High integrity, including maintenance of confidential information. Must be able to exercise good judgment and positively influence others, including handling confrontations with poise and efficiency.
• Knowledge of insurance, especially Medicare and Medicaid, rules and guidelines. 
• Identify insurance company or proper party (patient) to be billed; identify and bill secondary or tertiary insurances. 
• Perform coding and billing tasks on a computerized health information technology (HIT) system

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.

Work Environment: 
This position offers a hybrid work environment, requiring a combination of remote and in-person work.

Travel Requirements:  This position requires travel.  

Job Type:  Full-time, Exempt

Compensation Range, DOE (Salary, Exempt): 
$70,000 - $80,000 per year

 We offer benefits including:

• Medical
• Dental
• Vision
• Life Insurance
• Long Term Disability
• 401k with match and generous PTO
• Tuition Assistance
• EAP (Employee Assistance Program)
• Career Growth opportunities! 

Why Join Livara Health, Inc.?

Livara Health, Inc., is a great place to be if you are passionate about helping others and want a place to grow!

Livara Health, Inc., is an Equal Opportunity Employer: we value diversity. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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