Claims & Billing Manager, Navigation Service Delivery

THE ROLE:

We’re looking for a Claims & Billing Manager, Navigation Service Delivery to lead a team of Claims and Billing Specialists who help our members understand their medical bills, benefit coverage, and resolve billing or claims processing issues. You will be accountable for the day-to-day management of your team and working in conjunction with other department leaders to deliver results for our members. Managers are responsible for handling escalations, driving positive member experiences, and supporting their teams who operate in an omnichannel contact center environment.

WHAT YOU'LL DO:

• Lead, motivate, coach, and mentor your team of Claims & Billing Specialists to deliver world-class concierge service.
• Drive KPI Performance.
• Assign, review, and monitor employee workload to ensure timely and accurate completion of member requests.
• Perform daily, weekly, and monthly reviews of performance analytics to drive member experience, identify process improvements, and otherwise manage the business.
• Develop, update, and maintain Standard Operating Procedures to support team and department.
• Work in cross-functional teams to drive training, quality, workforce, and Product improvements. 
• Serve as a subject matter expert for internal teams (CSM, Product, Sales, etc.).
• Conduct weekly coaching sessions, quality reviews, and performance evaluations. 
• Interview, hire, and onboard new team members.
• Handle escalations including conducting RCA and developing action plans to address opportunities.
• Ensure compliance with policies, procedures, and regulations (HIPAA, etc.).
• Support new organization launches, refresher training, and account-specific training.
• Support program growth and efficiency through participation in operational projects to drive efficiency including improvements in internal tools, IVR, reference materials, etc.

WHO YOU ARE:

• 5+ years of healthcare billing or claims processing experience
• 3+ years of contact center management experience preferred, but not required
• Strong understanding of benefit structures, adjudication rules, EOBs, etc.
• Strong communication skills and a demonstrated ability to translate complex topics into common speech 
• Bachelor’s Degree in Management or Healthcare highly preferred
• Strong coaching and mentoring skills with a passion for developing and growing your team
• High level of Emotional Intelligence (EQ)

• Coachable, focused on continued growth and development
• Ability to work a flexible schedule including evenings and weekends as needed
• Strong team-building, collaboration, and motivational skills
• Ability to effectively influence and communicate to all levels of the organization, with excellent written and verbal communication skills
• Builder and self-starter who is willing to develop SOPs, drive system recommendations, address operational gaps, and continuously look for ways to improve the business and member experience
• Highly organized, with experience in project managing, creating roadmaps, and executing with accountability
• Ability to multi-task in a fast-paced environment
• An analytical background, with experience analyzing data (agent level performance, queue data, and overall business performance metrics) to identify gaps and actionable insights

Salary: $75,000-$90,000/year

CYBERSECURITY AWARENESS NOTICE

In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment. If you have any questions about a suspicious interaction with Rightway, please feel free to reach out to us at hr@rightwayhealthcare.com.

ABOUT RIGHTWAY:

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them.

Since its founding in 2017, Rightway has raised over $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We’re headquartered in New York City, with a satellite office in Denver. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.

HOW WE LIVE OUR VALUES TO OUR TEAMMATES:

We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our following core values:

1) We are human, first
Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to—and hear—each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding.

2) We redefine what is possible
We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems.

3) We debate then commit
We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.

4) We cultivate grit
Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity.

5) We seek to delight
Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success.

Rightway is a healthcare company looking to improve healthcare outcomes for everyone, everywhere. With that in mind, we have to consider what is good for the health of our team, the company, and the communities we operate in. As such, Rightway has determined a mandatory COVID-19 vaccination policy for all employees, in combination with other safety precautions, is the best way forward.

Rightway is PROUDLY an Equal Opportunity Employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.