Director, Revenue Cycle Management

K Health · New York City, NY

Company

K Health

Location

New York City, NY

Type

Full Time

Job Description

Who we are:

K Health is a venture-backed, fast-growing start-up with a mission to use the power of shared knowledge to get everyone access to higher quality, more affordable health care. We’re looking for mission-driven individuals to join our growing team and help us eliminate healthcare inequalities and build a better, healthier future for us all. 

Named as one of FastCompany's Most Innovative Health Companies of 2022 and to the 2021 CNBC Disruptor 50 list, K Health is using Artificial Intelligence (AI) to build the smartest digital healthcare platform in existence. Our data-driven app brings together the knowledge of thousands of doctors and the anonymous medical records of millions of people to help diagnose and treat what’s wrong. We offer a free symptom checker and 24/7 access to doctors to ask questions, refill prescriptions, get care for your kids, and more. Right from your phone—no insurance needed.

Since we were founded in 2016, K Health has raised over $270M in VC funding and our Series E funding round brought us to Unicorn status. Our current partners include the Mayo Clinic Platform, Anthem, and Maccabi Health Services.

About the role:

K Health is looking for a dynamic individual who will serve as a subject matter expert of information regarding the impact of coding and documentation as it relates to patient care, quality outcomes measures, and correct reimbursement. You will play a critical role in ensuring accurate and compliant coding practices, conducting audits, and maintaining the highest level of data integrity. Your expertise in medical coding and auditing will contribute to the overall efficiency, regulatory compliance, and financial success of our organization.

What you'll be doing:

  • Accurately assign diagnostic and procedural codes to medical records using ICD-10-CM, CPT, HCPCS, and other relevant coding systems.
  • Review medical documentation to ensure coding accuracy, completeness, and adherence to established coding guidelines.
  • Verify medical records contain appropriate documentation to justify the codes assigned.
  • Resolve coding discrepancies or ambiguities by consulting with healthcare providers or relevant stakeholders.
  • Ensure coding meets regulatory requirements and applicable coding guidelines, including Center for Medicare and Medicaid Services (CMS), Office of the Inspector General (OIG), HIPAA, and other relevant standards.
  • Maintain up-to-date knowledge of coding guidelines, regulatory changes, and industry best practices, as well as payer specific requirements and regulations.
  • Act as a liaison to clinical staff for any coding related issues or questions.
  • Educate and guide clinical staff on proper documentation and trends that could cause delay or denial of claim submission. 
  • Conduct comprehensive audits of medical records, claims, and coding processes to identify potential compliance issues, coding errors, or fraudulent activities.
  • Review charts for accuracy of CPT and ICD-10-CM diagnosis codes and documentation in support of all codes assigned.
  • Prepare reports for the leadership team on findings from billing and coding audits, including a regular assessment of the company’s current coding performance, recent trends, and corrective actions taken.

What we're looking for:

  • 6+ years of medical coding and auditing experience.
  • In-depth knowledge of ICD-10-CM, CPT, insurance reimbursement, and coding and billing compliance regulations, including CMS guidelines and HIPAA requirements.
  • Strong understanding of medical terminology, anatomy, physiology, and disease processes.
  • Certification Professional Coder (CPC) certification, CCS, or CPMA certification required.
  • Certified Professional Compliance Officer preferred.
  • Experience in adult education and training required.
  • Excellent analytical skills with a keen eye for detail and the ability to spot discrepancies.
  • Proficient in using coding software, electronic health record (EHR) systems, G-suite, and related healthcare technology.
  • Strong communication skills with the ability to effectively interact with physicians, healthcare providers, and other key stakeholders.

Benefits & Perks:

  • Hybrid work schedule with weekly lunches and stocked fridges 
  • Monthly social committees for company events
  • 20 paid vacation days & 5 sick days per year 
  • 10+ Holidays plus 10 additional 3-day weekends per year 
  • Stock options for every full-time employee 
  • Paid parental leave
  • 401k benefit
  • Commuter Benefits 
  • Competitive health, dental, and vision insurance options 
Compensation:
$83,000—$91,000 USD

K Health offers competitive compensation packages along with stock options based on industry benchmarks for function, level, and geographic location. Offer amounts are determined by multiple factors such as a candidate's experience and expertise.

We’re deeply committed to building teams as diverse as the patients we serve and strive to cultivate an environment where everyone can bring their most authentic self to work. We depend on our differences to make our team stronger, our workplace more dynamic, and our product accessible to all of our users. 

K Health is proud to be an Equal Opportunity Employer and considers applicants for employment regardless of race, ethnicity, religion, color, national origin, ancestry, disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, sexual orientation, pregnancy, childbirth and breastfeeding, age, citizenship, military or veteran status, or any other class protected by applicable federal, state, and local laws.

Privacy Disclosure for Job Applicants Residing in California: As aligned with the California Consumer Privacy Act (CCPA) and the California Privacy Rights Act (CPRA), we bring the following information to your attention regarding the personal data we collect and handle about you: Data Categories We Accumulate: We gather and use data that you voluntarily provide to us, including your identity, contact details, educational background, career history, and all information embedded in your resume and/or application documents. Reasons for Processing Personal Data: This data is used to assess your suitability for the position(s) you're interested in and to potentially reach out to you regarding employment opportunities. Third Parties We Might Share Personal Data With: Your personal data might be shared with our service providers (e.g. our applicant tracking system, Greenhouse), affiliated entities, and other third parties as required for our recruitment and credentials verification process. Retention of Personal Data: Any information you submit into our applicant tracking system will be retained indefinitely.

California residents, under California law, possess certain rights including the right to request access to, deletion of, or to opt out from the sale of your personal data, provided that our company engages in selling your data. To learn more or to exercise these rights, please refer to our Privacy Policy or get in touch with us via our Contact Us page. By submitting your job application, you confirm that you've comprehended the terms of this disclosure.

Apply Now

Date Posted

08/12/2023

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