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Job Description

Job Description

Ria Health, recognized as the leading national telehealth provider specializing in alcohol use disorder (AUD) treatment, recently raised $12.5 million through a Series B financing led by Peloton Equity. Our existing investors SV Health, BPEA and SOSV also participated in the Series B. The investment will further the momentum of commercial partnerships that include regional and national health plans, including Anthem Blue Cross Blue Shield, UnitedHealth Group Optum, Beacon Health Options, Highmark Health, and Magellan Health. Ria Health will enable patients to achieve long term success in reducing or eliminating their alcohol consumption, and live healthier and happier lives. We are seeking a Director of Revenue Cycle Management to join our rapidly growing team.

JOIN THE RIA HEALTH TEAM

Join the team that integrates medical care, behavioral support, and technology tools to help members achieve their personal goals in treating heavy alcohol use and addition. Ria Health delivers a Joint Commission accredited program that leverages evidence-based pharmacotherapy, targeted protocols, and a technology platform to help members achieve lasting improvements in their quality of life. Ria’s published outcomes data set the standard for effectiveness in alcohol treatment. The Ria program is delivered through telehealth and partners with physicians and nurse practitioners to provide clinical expertise and manage care and outcomes for Ria Health members.

WORK AS A RIA HEALTH BILLING SPECIALIST

The Billing Specialist has a strong background in medical billing and revenue cycle management, with proven experience in claim resolution, payer contracts, and patient account reconciliation. This candidate takes pride in their professionalism, accuracy, and attention to detail, ensuring that billing processes are completed efficiently while maintaining compliance with payer requirements and HIPAA guidelines. The Billing Specialist communicates clearly and effectively with insurance companies, patients, and internal team members, providing reliable support to the Director of Revenue Cycle.

This is a hybrid role based in Connecticut, requiring a few in-office days each month.

BILLING RESPONSIBILITIES :

Communicate, analyze and reconcile billing and collections issues

Analyzes and resolves claim rejections and denials related to billing

Work follow up on all insurance claims and reconcile overpayments

Communicating with insurance company representatives to track payments and confirm patient coverage

Maintain a high degree of professionalism in all daily correspondence

Basic knowledge of how to perform timely insurance benefit verifications to determine eligibility and cost-share amount for new and existing patients

Basic knowledge on how to submit prior authorization requests to insurance carriers

Obtains and tracks authorizations as required by payers

Understand payer contract and billing requirements

Experience in data entry of healthcare claims

Regularly review contract terms and conditions to confirm billing accuracy

Proficient computer skills to navigate quickly through our practice software system

Assess patient balances to ensure accurate billing and provide follow-up on patient balances

Other duties and responsibilities as directed by Manager

• Maintain HIPAA guidelines and high level of discretion due to the sensitivity of information

JOB REQUIREMENTS :

Associates degree or equivalent experience preferred

3+ years of experience in the medical billing field

Strong medical coding, ICD-10, CPT knowledge preferred

Familiarity with medical terminology and billing processes / principles

Familiarity with medical policies and payer contracts preferred

Maintain integrity and tenacity while working accounts

Ability to identify, understand, and escalate potential issues

Ability to collaborate with key internal and external teams

Ability to solve problems and set priorities

Ability to work independently with minimal supervision

Must be organized and self-motivated

Attention to detail and ability to multitask

Exceptional written and verbal communication skills with internal and external customers

PROVIDE CARE AMID COVID19

With the COVID19 crisis, there has been a tremendous increase in anxiety, trauma, and stress for millions of people, increasing the misuse of alcohol. As a center of excellence in treating alcohol misuse, Ria Health has been enlisted to rapidly provide care to people across the United States, which will require additional care team members. We seek care team members who are motivated to provide high quality, patient-centered, evidence-based care in a telemedicine setting. In the immediate term, opportunities include full-time, part-time, and contracted positions.

ENJOY RIA HEALTH BENEFITS

Join a team of Mission driven professionals dedicated to offering a next-generation solution in the treatment of heavy alcohol use and addiction

Experience professional growth within a rapidly expanding tech-healthcare company

Competitive compensation

Telehealth training and development

Unlimited PTO for full-time team members

EQUAL EMPLOYMENT OPPORTUNITY

Ria Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Ria Health Mission :

We strive to help adults who are in distress due to alcohol misuse and who are courageous enough to take steps to change their relationship with alcohol. To uphold our mission we provide compassionate high quality evidence-based care that instills dignity and encouragement. We accomplish this through our team of dedicated healthcare professionals removing barriers of stigma, time and affordability by providing our services through telehealth. We achieve our mission by helping people achieve optimal well being through changing their relationship with alcohol.

Ria Health Vision :

Be a sustainable business that provides accessible, effective and affordable evidence based behavioral health care to all. By building a values based culture where Rianistas are excited and engaged in doing their best quality work teaming to impact millions of lives of our members, their families and their communities.

Ria Health Values :

Compassion – we promote a culture of empathetic care and communication. We actively listen, we always encourage and we provide support.

Integrity – we are honest, open, ethical and fair. We hold ourselves accountable when we make mistakes.

Teamwork – working together we will achieve great things.

Embrace Change – we work to drive improvement over perfection, measuring and questioning the status quo to make progress and enhancement.

Always Learning – We celebrate curiosity and discovery through development and research.