Bicycle Health

Auditor

• Responsible for examining medical records, clinical documentation and claims to verify the accuracy and completeness of assigned codes.
• Responsible for identifying discrepancies, errors and inconsistencies in coding and billing practice. Including the potential of fraud, waste, and abuse (FWA).
• Ensures all federal and state regulations, Medicare and Medicaid rules and other payer guidelines are being followed
• Creates reports on identified errors and trends and recommends process improvements to management
• Collaborates with compliance, billing, clinical and clinical leadership to resolve any coding discrepancies.
• Responsible for maintaining a tracking system for all audits/requests activity throughout all levels of appeals.
• Researches new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations.
• Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.
• Reviewing Chart Records to confirm accurate documentation to decrease audit concerns and documenting findings.
• Assisting our Compliance Officer with coding training documentation to better equip our providers
• Establishing workflows, policies and procedures, software analysis and maintenance and implementation of processes and communication plans for the facility's interactions with third party auditors
• Pre and post payment Medicare, Medicaid and commercial insurance reviews to ensure timely completion or review/audit documentation requests.
• Regular and predictable attendance is required.
• All other duties as assigned.

Revenue Cycle Management Coding Auditor

Recruitment

• Collaborate with hiring managers to understand technical job duties, responsibilities, and business requirements.
• Proactively build the candidate talent pool by seeking out and building relationships with top talent for current and future job openings within operations, including direct calls, networking, posting, and engaging on social media, sourcing candidates from various geographical areas, professional communities, companies, alternate industries, diverse groups,, hiring and community events, forums, job boards, etc.
• Develop position-specific sourcing strategies for hard to fill key roles ensuring there is an understanding of the professional experience, attitude, personality, ability, and skill set needed for a particular position.
• Become an expert on Bicycle Health so that you can speak knowledgeably to candidates about our business, patients, clinical model, positions and company culture.
• Own the full cycle recruiting efforts (planning, sourcing, selection, offer, and onboarding processes for assigned departments/roles and provide backup for other team members.
• Source and identify passive people to build our pipeline through use of Boolean, online tools, and unique sourcing techniques. Build out CRM functionality in Greenhouse and identify and execute on ways to keep candidates “warm” for critical roles.
• Own resolution/disposition of any/all talent acquisition problems, issues, and/or challenges.
• Provide feedback and drive continuous improvement activities to achieve goals.
• Work with vendors to optimize TA’s marketing budget. Evaluate, source and implement results driven solutions to creatively find and attract talent.
• Identify, propose and implement new ways to build awareness of Bicycle Health in new hiring markets.
• Focus on inclusive recruiting practices.
• Provide mentorship to more junior members of the TA team.

Senior Recruiter – Clinical and Business

Financial Planning and Analysis

• Build and maintain financial models, prepare regional financial reporting, and analyze KPI trends across different markets and service lines
• Analyze profitability by region, payor mix, etc to identify opportunities for growth and operational improvements
• Support the budgeting process, providing functional and regional support on revenue, expense and headcount planning to budget holders across the organization
• Partner closely with key business stakeholders to understand detailed drivers of the business, including market-specific drivers, and perform financial analyses to support business decisions
• Report and analyze new dimensions of measuring our profitability (payor, line of business, region, etc.) with a thorough understanding of key revenue, profit, and operational drivers
• Shape the future of our business through data-driven storytelling, crafting powerful insights that guide leadership decisions
• Support the company on special projects such as new service offerings, market expansion initiatives, and operational efficiency improvements
• Collaborate with the leadership team to deliver monthly reporting packages and KPI dashboards for presentation to leaders and the Board of Directors
• Create in-depth analyses to identify strategic and growth opportunities, assess competitive landscape, and develop business cases
• Translate operational insights into actionable recommendations by developing and monitoring KPIs to optimize resource allocation and reduce operational bottlenecks
• Develop regional performance reporting to track key metrics across different markets and identify trends in operational efficiency
• Work with regional teams to analyze capacity utilization, resource allocation, provider productivity, and patient flow metrics that impact financial performance and reduce bottlenecks
• Support regional expansion initiatives through market analysis and financial feasibility studies
• Collaborate with operations teams to identify cost-saving opportunities and process improvements
• Collaborate with C-suite leaders to surface critical financial metrics to inform strategic decisions on resource allocation, growth initiatives, and risk management
• Create executive-level analysis that bridges operational performance with financial outcomes
• Support cross-functional initiatives that require both financial modeling and operational understanding

Senior Analyst, Strategic Finance – Operations

Strategy

• Execute payor strategy, and business plan to contribute to departmental sales goals.
• Initiate, negotiate, renegotiate and close payout contracts, letters of agreement and contract revisions, as prioritized by claims volume, market trends and/or corporate leadership.
• Initiate and nurture regional and strategic account relationships at multiple levels with the partner.
• Maintain a strong focus on helping the market understand Bicycle Health’s unique value proposition.
• Understand and execute financial modeling to assess the sustainability of Payors rate structure and/or proposed rates for new accounts or account rate changes.
• Contract with new partners and negotiate sustainable rate schedules implementing bundled or value-based pricing strategies whenever possible.
• Ensure contract language is consistent with Bicycle Health’s interests.
• Implement Payor Contracts to maximize potential revenue and pull through opportunities.
• Expand upon existing relationships to increase the value of the account by renegotiating rates, introducing value-based models, and/or expanding go-to-market efforts.
• Complete all designated profiles and documentation on new deals to be reviewed.
• Document progress in sales support applications and communicate consistently regarding sales forecasting.
• Become a subject matter expert regarding payor contract implementation and strategic account management for assigned accounts.
• Partner with the internal team included Revenue Cycle Management, Licensing and Credentialing, Compliance, Marketing, Operations, Enrollment and all other stakeholders to ensure contract alignment and execution.
• Regular and predictable attendance is expected.
• All other duties as assigned.

Payor Strategy Manager

Customer Support

• Serve as key point-of-contact for patients through their treatment and recovery process.
• Deliver world-class patient experience via phone, chat, or email while embodying the Bicycle Health AAA experience through timely response and resolution of any administrative, medication or service management issues that may arise.
• Adhere to defined workflows to ensure patients and clinicians receive consistent, high-quality support and maintain clean documentation of care resolution support provided.
• Participate in a productive, tech-enabled, and team-oriented culture that seeks to create a best-in-class care experience for patients through the Bicycle Health app.
• Master our technology suite, including the Bicycle Health app, G-suite, Zoom, FreshWorks, Athena, among others to efficiently triage and resolve administrative and logistical tasks that support patient care.
• Collaborate with other medical and behavioral health clinicians to deliver successful telehealth care support.
• All other duties as assigned.

Revenue Cycle Management Coding Auditor

Senior Recruiter – Clinical and Business

Senior Analyst, Strategic Finance – Operations

Payor Strategy Manager

Clinical Support Specialist