The Cadence Solutions team seeks an experienced, strategic, and hands-on Director of Billing Operations to lead and evolve our billing function within our Growth Operations Team. This role is designed for a player-coach who can manage the daily billing operations while crafting and executing a forward-thinking roadmap that aligns billing processes with the company's long-term goals. Your strategic initiatives will drive growth through revenue optimization, commercial reimbursement expansion, and preparation for emerging models like Advanced Primary Care Management (APCM).
As the Director of Billing Operations, you'll play a crucial role in ensuring billing accuracy, compliance, and financial alignment across our Remote Patient Monitoring (RPM), Chronic Care Management (CCM), future APCM programs, and commercial payors. This includes auditing practices, optimizing workflows, implementing automation, and facilitating collaboration with finance, product, and technology teams to streamline billing processes and maximize revenue.
WHAT YOU'LL DO: Operational Leadership: Oversee the day-to-day billing operations to ensure accurate, compliant, and timely billing practices. Responsibilities include validating insurance plans, calculating patient copayments, and ensuring accurate coverage for RPM, CCM, and APCM services.
Payor Contract Management & Patient Financial Guidance: Lead payor contract management, maintaining relationships with insurance providers and ensuring our billing aligns with contract terms. Help patients better understand financial obligations, providing clear and accurate information to support informed decision-making regarding their coverage and copayments.
Strategic Process Improvement: Design and execute a roadmap for continuous process improvements to reduce errors, enhance efficiency, and align billing functions with Cadence's growth trajectory. Work with product and technology teams to implement automation and data-driven decision-making tools that streamline billing processes.
Audit & Compliance Management: Conduct comprehensive audits of billing operations to ensure alignment with collected data, health regulations, and billing codes. Develop robust audit frameworks to maintain the highest standards of accuracy, compliance, and reliability, staying informed of regulatory changes to update policies as needed.
Revenue Growth & Expansion Initiatives: Lead strategy to expand into commercial insurance markets by developing billing processes for new codes, ensuring we're set up for success in these markets. Support the integration of APCM billing within Cadence, aligning with the future of value-based care as outlined in CMS's 2025 proposed rule.
Cross-Functional Collaboration: Collaborate closely with finance, product, and technology teams to ensure billing processes align with Cadence's financial goals, reporting requirements, and technological infrastructure. Coordinate with external partners, including insurers and healthcare providers, to resolve issues and facilitate smooth billing operations.
Performance Monitoring & Reporting: Analyze billing performance data to identify trends, forecast opportunities for growth, and make informed, data-driven recommendations to senior leadership. Provide regular updates on KPIs, compliance, and operational metrics.
WHAT YOU'LL NEED: 7+ years of experience in healthcare billing operations, preferably within health tech, with preferred demonstrated expertise in RPM, CCM, and understanding of APCM billing concepts. Proven success in managing and improving billing teams, implementing audit processes, and maintaining regulatory compliance with Medicare, Medicaid, and commercial insurance guidelines. Proficient in using billing software, EMR systems, and billing automation tools. Experience with process automation, data analysis, and telehealth platforms is highly valued. Strong leadership, organizational, and communication skills with the ability to manage a remote team effectively. Bachelor's degree in Business, Healthcare Administration, Finance, or a related field; advanced degrees or certifications are a plus. WHO WE ARE:The work we do at Cadence each day changes lives and as such, the stakes and the pace are high. Our fully remote work environment values autonomy, curiosity, and experimentation. Our team is challenged with new opportunities daily. We are growing fast and want team members who are excited about tackling an endless list of big and complex problems. Cadence has rapidly grown into one of the largest remote patient monitoring platforms in the US, and we are just getting started.
We seek ambitious individuals who are passionate about lifelong learning and eager to be part of a winning team that's shaping the future of healthcare. In return, we provide competitive total compensation packages with meaningful equity in one of the fastest growing healthtech companies in the US. If you're ready to make a difference and drive positive change, we invite you to join us at Cadence.
WHAT YOU'LL GET: Cadence recognizes the unique needs of its diverse, distributed workforce and seeks to provide an inclusive work environment for its world-class clinicians and technologists.
Company culture all about impact, shared growth mindset, empowerment, and integrity An opportunity to help improve the quality of life of millions of Americans Medical, dental, and vision insurance Competitive salaries and stock options TelaDoc (virtual primary care), and TalkSpace (online mental health services) memberships Discounted Peloton memberships Unlimited PTO and paid holidays Remote equipment setup and home office stipend Paid Parental Leave 401K and 401K match Charitable Donation Match program Expected compensation range: $130K-$180K Location: Remote
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