Revenue Cycle Management Consultant

Remote • Consultant

About Remo

Remo is building the new standard of dementia care. As a virtual dementia care provider, our expert clinical team designs personalized, comprehensive care around patient and family needs (instead of a one-size-fits-all approach). We empower family caregivers by connecting them with a community of other caregivers, expert-created content, and practical tools to manage the entire dementia journey – from anywhere, at any time. Our mission is simple — to provide accessible, comprehensive, quality dementia care for every person who needs it.

DESCRIPTION OF CONSULTING SERVICES

1. Design and implement Remo’s Revenue Cycle Management (RCM) processes

   1. Own and build the full RCM journey at Remo (from front end eligibility checks through claims adjudication and A/R).  This work will include mapping existing processes as well as articulating the requirements for new processes and product functionality.  Deliverables from this work will include:

      1. Review of Remo’s clinical service design map – what clinical services are rendered, by whom on the care team, at which time intervals

      2. End-to-end process map that links RCM phases to the clinical service design – including typical points of friction / drop off / and strategies to mitigate the sources of underpayment or claims denials

      3. Mapping of the clinical service design to GUIDE stipulations and requirements – specifically accounting for new G-codes, respite payments, etc.

   2. Create the training and onboarding materials for the multidisciplinary care team around documentation / billing / etc.  These materials should provide them with the “paint-by-numbers” understanding of RCM at Remo, and set expectations of how to meet timely and accurate documentation and coding standards. 

   3. Create the appropriate governance structures for RCM protocols, processes, etc. This work will include partnering with our Licensing & Credentialing and Enrollment specialist.  The governance structure should include processes for claims submission, denials, A/R, and other fundamental JTBD of RCM 

2. Oversee the development of RCM in Remo Pathways

   1. Serve as the SME for our Candid implementation.  Our product team has done the initial phases of technical integration – we need a SME with end-to-end RCM expertise to oversee the final parts of the integration and testing ahead of care delivery go-live.  The goal of this deliverable is to ensure that the work from workstream #1 gets built into the product (read, what’s programmable gets programmed, what needs to be a human process gets clearly spelled out and planned for).

   2. Collaborate with the Chief Product Officer, Chief Design Officer, and Head of Clinical Operations to align our clinical service design (what gets delivered, by who on the care team, at what cadence), to the appropriate E/M visit types,

      1. clinical documentation, and CPT codes.  This work will include providing specific product requirements for our “Notes” and “Billing” features.  The service design will be consistent regardless of contract (e.g. GUIDE / FFS / MA Health Plan), how it gets paid for will differ.  Our product — and its integration with Candid — must generate the correct claim (rendering service provider, site of service, E&M documentation and coding, etc) and route it to the correct payor. 

3. Support Remo in staffing our RCM function

   1. Review the Org Chart and make recommendations on setting up the RCM function for the next 12-18 months.  We have a POV on staffing this function, but you’re the expert.  Taking into account our growth projections, our contracts, and our clinical model, where do we need to evolve our staffing plan?

   2. For current open roles, review and refine the existing JDs, interview processes, and candidate exercises 

   3. Participate in the interview process – including sourcing, interviewing, and closing the right candidate.

   4. Build an onboarding and training experience that sets the new team member up for success at Remo.

   5. Based on the org chart recommendations from 3a, repeat A-C for additional necessary roles (e.g. Claims Manager, Contracts Manager, etc.)

At Remo Health, we value diversity in the workplace because it allows us to better understand and meet the needs of our customers and the communities we serve. We want to ensure every job applicant is treated fairly and with respect regarding race, national or ethnic origin, religion, age, gender, sexual orientation, or disability. If you require any support in the application process, including disability accommodation, please contact hr@remo.health.

We use E-Verify to confirm the identity and employment eligibility of all new hires: Participation Poster (PDF), Right to Work Poster (PDF). Background checks are required for all new hires.