Revenue Cycle Specialist

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community. 

Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.

Our Values:

  • Aim for Understanding
  • Be All In
  • Bring Your Whole Self
  • Lean Into Discomfort
  • Put Members First

About the Role:

The overall purpose/business need for the role is to perform transactional work in the practice management system critical to the revenue cycle and to support the ongoing work facilitated by the Revenue Cycle Associates in relation to the work they undertake with the market hubs. 

  • Manages the weekly CARC to athena Kickcode mapping and the subsequent updating of all applicable athena worklists
  • Manages all unpostables in athena along with all non-athena remittances.  Any remittances that require Finance visibility will be routinely sent to Finance.
  • Daily review of the Default Worklist in athena to troubleshoot why transactions are failing to ‘default’ and not established worklists.
  • Daily review of the CBO and athenahold buckets in the software to ensure accurate ownership of any issues causing these transactions to be held.
  • Identification, review, and subsequent disposition of all self-pay balances
  • Assist with any ‘clean-up’ to pre-claim transactions (e.g., insurance updates, carve-out case policies, review of patient eligibility, reclassification of insurance packages to the correct package, etc.).
  • Review of all newly implemented athena custom rules to ensure that the expected logic is accurately reflected by the transactions shown in the production environment.   
  • Daily monitoring of the athena Enrollment Worklists for any transactions moved from athena to CBH that require work/follow-up
  • Focal point of all CPT add requests.  This entails researching the code, determining if the service is a valid billable service, and what the charge should be based on established methodology.  Once all questions have been answered if the code should be added to the athena fee schedule, update athena accordingly.
    • Maintain all source information of fee requests 
    • Maintain the POC testing spreadsheet for all markets
  • Manage all payor portal access for the RCM Team
  • Maintain the capitation wizard setup for all new risk-based insurance contracts
  • Maintain all allowable fee schedules for FFS contracts
  • 100% claim review of all new payor claims for at least two weeks to ensure all claim elements look structurally correct and any custom rules are firing correctly.  
  • Weekly review of athena deposit batches to ensure EFT and ERA is accurate.

Requirements for the Role:

  • HS Diploma/G.E.D
  • Minimum One (1) year of physician-based (PB) revenue cycle experience preferably in a medium to large-scale central business office (CBO)
  • Excellent ability to key transaction work in the practice management system (PMS) with superior quality while maintaining a high degree of production.  Keen ability to identify issues within the practice management systems (PMS) that look incorrect and troubleshoot the possible root cause.  Strong understanding of the revenue cycle workflow and applying transactional work in the PMS to support that workflow.  Raise issues in a proactive manner to ensure that transactional processing supports the expected workflow.
  • Basic understanding of the integration involved with scheduling, registration, EMR, and billing components of the EMR/PMS.  Ability to take existing revenue cycle knowledge and apply those concepts to the nuances and variations that exist at Cityblock.  Basic understanding of revenue cycle financial/revenue terms (eg, capitation, write-offs, AR, recoupments, etc..). 
  • Possesses a basic understanding of the priority of work tasks and structures one day to ensure all necessary tasks are completed on time and with a high degree of accuracy.  Communicates to supervision when work priorities are unclear.  Works with minimal direct supervision.  Consistently maintains at least minimal productivity standards for the assigned work.  
  • Excellent attention to detail with a solid ability to use Microsoft and/or Google suite software tools (eg, Word, Docs, Sheets, Excel)

What We’d Like From You:

  • A resume and/or LinkedIn profile 

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The expected salary range for this position is $51,503 to $71,000. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. APPLY HERE