ReKlame Health

Medical Billing and Coding

• Lead and oversee all aspects of the billing process, including claims submission, payment processing, and account reconciliation, ensuring accuracy and efficiency.
• Ensure accurate, compliant coding with ICD-10, CPT, and HCPCS systems to optimize first-pass claim submissions and maximize revenue for patient care and procedures.
• Establish scalable workflows to address multi-state billing complexities, with a focus on state-specific Medicaid requirements and streamlined reimbursements.
• Monitor and implement changes in Medicare, Medicaid, and other regulatory guidelines, ensuring full compliance across all billing and coding processes.
• Conduct regular audits to uphold coding standards, identify gaps, and ensure accurate documentation and billing practices.
• Partner with providers, administrative teams, and payers to address documentation gaps, efficiently resolve coding challenges, and reduce claim denials.
• Identify skill gaps and develop tailored training initiatives, such as workshops, coaching sessions, and resource playbooks, to enhance team capabilities.
• Serve as the expert in coding and billing complexities, particularly in navigating multi-state Medicaid and Medicare nuances.
• Leverage emerging technologies and automation tools to optimize billing operations, enhance team performance, and support long-term cost efficiency.

Medical Billing Manager

Insurance

• Conduct insurance verifications, ensuring verifications are run in a timely manner
• Communicate one-on-one with patients, providing accurate and current information regarding their coverage
• Run prescription history reports through a prescription monitoring platform
• Enter client personal health information and other clinical data
• Perform other tasks assigned by the Lead Care Navigator
• Contract for 40 hours per week on tasks assigned according to the job description

Insurance Verification Specialist, Healthcare

Manager

• Own and actively manage a territory pipeline, self-generating the majority of leads and leveraging CRM to track activities, progress, and ROI on outreach efforts.
• Achieve or exceed weekly activity goals (e.g., 40-50 touchpoints, 12 meetings) and meet monthly partnership, referral volume, and admission targets while maintaining a high conversion rate from referral to admission.
• Drive growth by identifying and pursuing new business opportunities, establishing referral networks, and forming long-term collaborations.
• Orchestrate the end-to-end partnership lifecycle, including initiation, contract negotiation, implementation, and performance assessment.
• Serve as a persuasive advocate for ReKlame Health during partnership discussions, demonstrating a nuanced understanding of the organization’s value.
• Develop and sustain partnerships with healthcare providers and community organizations, proactively identifying high-value opportunities aligned with market trends and community needs.
• Act as a trusted representative of ReKlame Health within the community, cultivating credibility and trust among key stakeholders.
• Collaborate across departments (Marketing, Growth, Operations, Customer Success) to ensure partnerships are integrated into service delivery and operational infrastructure.
• Analyze partnership performance data to refine strategies, optimize outcomes, and provide regular feedback to internal teams.
• Define and monitor measurable objectives and key performance indicators related to partnerships, referrals, and business growth.

Medical Billing Manager

Insurance Verification Specialist, Healthcare

Regional Outreach Manager