Theoria Medical

Procurement

• Develop and execute targeted sourcing strategies for active and passive candidates.
• Utilize recruitment tools on platforms like LinkedIn Recruiter, Greenhouse, Practice Match and Doc Café.
• Conduct comprehensive market research to map talent pools and target competitive companies.
• Capitalizing on prior sourcing experience to add a creative flair to attract talent when needed.
• Craft high-converting, personalized outreach campaigns to engage cold leads.
• Act as the primary, high-charisma ambassador of our employer brand via written communications.
• Follow-ups with active and passive candidates.
• Populate and organize Greenhouse (ATS).
• Deliver talent pipelines to champion company initiatives.
• Schedule interviews for the recruiters.

Sourcing Specialist, Healthcare

Recruitment

• Serve as the dedicated point of contact for applicants, building a deep knowledge of Theoria Medical's values and mission.
• Drive applicant engagement through proactive outreach and timely follow-ups that increase offer acceptance.
• Lead outbound recruiting efforts to our highest priority prospects, via personalized emails and calls.
• Manage and respond to applicant questions in a timely, professional manner.
• Track and analyze key recruiting metrics to improve hiring strategy and outcomes.
• Collaborate with talent acquisition team, sourcers and hiring managers to create feedback loops that improve candidate experience
• Make process improvements based on feedback from providers and internal stakeholders to improve the overall recruiting experience, both qualitatively and quantitatively

Provider Recruiter

Manager

• Lead and manage the revenue cycle operations, including but not limited to billing, holds/credentialing, denials, collections, and accounts receivable management.
• Assist in developing and implementing KPIs and policies and procedures to ensure accurate and timely submission of claims, reduce denials, and increase collections.
• Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff, third party vendors and revise policies and procedures.
• Identify and resolve revenue cycle issues, including coding and billing errors, incomplete or inaccurate patient information, insurance prioritization and other issues that may impact revenue.
• Monitor and analyze revenue cycle metrics, including accounts receivable aging, claim submission, payment turnaround times, and denial rates.
• Analyze billing and claims for accuracy and completeness; follow up with RCM teams and third party vendors on work queues, pending claims and unpaid AR.
• Spearhead the resolution of rejected or underpaid claims by conducting targeted appeals and payer negotiations.
• Analyze and manage overpayments from payers as well as implementing policies to reduce denials and refunds.
• Work with credentialing, billing and coding staff to ensure compliance with regulatory requirements, including HIPAA and other federal and state regulations.
• Develop and maintain strong relationships with RCM Directors, HR, Clinical Operations and Credentialing departments to ensure a smooth revenue cycle operation.
• Review and respond to various payor correspondence
• Communicate with patients and clients

Manager, Revenue Cycle Management

Medical Billing and Coding

• Conduct Coding Audits
• Perform detailed reviews of medical record documentation and coding to ensure accuracy, completeness, and compliance with ICD-10-CM, CPT, HCPCS, and payer guidelines.
• Identify and Mitigate Risks
• Analyze audit findings to identify compliance trends, risks, and opportunities for improvement.
• Recommend and support corrective action plans.
• Provide Education and Training
• Develop and deliver educational sessions and one-on-one guidance for physicians and staff regarding coding best practices and compliance standards.
• Stay Up to Date on Regulations
• Maintain current knowledge of CMS guidelines, federal and state regulations, and industry coding standards.
• Research and interpret new coding and billing policies.
• Respond to Inquiries
• Serve as a resource for coding, billing, and documentation compliance questions across departments.
• Prepare Reports
• Document audit findings and prepare clear, concise reports for leadership outlining risks and recommendations.
• Investigate Compliance Issues
• Conduct investigations into potential non-compliant activities or billing discrepancies and assist in identifying root causes and solutions.
• Collaborate Across Departments
• Partner closely with billing, revenue cycle management, providers, and operational teams to support compliant and efficient workflows.

Sourcing Specialist, Healthcare

Provider Recruiter

Manager, Revenue Cycle Management

Medical Coding Compliance Specialist