Sword Health is looking for someone with a background in Revenue Cycle Management (RCM) and an understanding of the mechanics and complexity of healthcare reimbursement. We are seeking an individual who thrives in working cross functionally and is passionate about digging into Product, Commercial and Operational processes that tie directly to Sword product monetization. This individual will be instrumental in independently executing on organization-wide initiatives related to reimbursement but also in improving existing RCM processes that support our exponential growth. This person should be comfortable manipulating data to report on the financial stability of our business directly to leadership.
In summary, we are looking for an individual who is a self-starter, passionate about Revenue Cycle, someone who can see the ‘big picture’ but is also willing to roll up their sleeves and get their hands ‘dirty’. Finance and accounting experience is a plus, but not required. Startup experience is a plus but not a must. The ideal candidate will have experience in Revenue Cycle and/or Healthcare Consulting.
• Independently own Revenue Cycle initiatives from inception through execution, building comprehensive project plans and working with cross functional stakeholders as needed
• Build scalable billing practices from pre-submission to post-submission with the ultimate goal of accelerating cash collections
* Project manage parts of the entire Revenue Cycle function in regards to setting up new payment structures as Sword Health expands product offerings
• Identify and implement areas of improvement in Sword’s revenue cycle, while also developing documentation for how to achieve these
* Examples: Claims submission & Rejection troubleshooting, Denials and A/R management, accelerated cash collections
• Work cross-functionally with the Product team to introduce more automation in our claim and invoice billing processes
* Work closely with the engineers to test new billing tool features and further automate end-to-end revenue cycle processes
• Collaborate with the Data / Analytics team to build reporting related to RCM KPIs.
* Report out on key revenue cycle metrics (e.g. denial rate, write-off percentage, charge lag and time to cash) and identify ways to improve these moving forward
• Own the end-to-end new client billing lifecycle which includes participating in external calls with clients, payers, health plans; representing Sword as the reimbursement SME
* Confidently explain Sword’s reimbursement model and work with external partners to obtain any necessary information for accurate and timely collections
• Collaborate cross-functionally with Commercial and Legal teams to ensure we are able to bill our new clients, and escalate any reimbursement issues as needed
• Train and educate any new RCM team members on best practices and industry benchmarks related to digital health reimbursement
• At least 1.5 – 2 years of experience in healthcare provider revenue cycle, preferably in a consulting or analytics role
• Working knowledge of industry best practices in RCM processes: billing, charge capture, contractual adjustments, third-party reimbursements, and cash collections Experience working cross-functionally with different teams and project managing internal projects with multiple competing stakeholders
• Attention to detail and comfort independently solving problems
• Efficient written and verbal communication skills
• Advanced Excel skills
• Persistence when working and communicating with insurance payers
• Fundamental knowledge of revenue integrity (i.e. CPT and ICD-10 coding) Comfortable working with the ambiguity of a fast-paced startup
• Degree in healthcare management, accounting, finance or business preferred, but not required