Are you passionate about making a meaningful impact in perinatal mental health care? Here's your chance to be a vital part of FamilyWell's mission to enhance access to high-quality, equitable, and affordable mental health services for pregnant and postpartum individuals across the U.S.

Background:

FamilyWell is the first behavioral health start-up to implement a perinatal collaborative care model that embeds a wrap-around mental health program directly into OB/GYN practices for pregnant and postpartum individuals. Our mission is to solve the maternal mental health crisis by increasing access to equitable, affordable, and accessible mental health care. Our specialized care team consists of social workers, coaches, therapists, and psychiatric providers in the OB provider’s clinical workflow (both in-person and virtually), ultimately becoming the behavioral health arm of the OB/GYN practice.

Role:

As a Health Plan Operations Manager, you will be responsible for the smooth and efficient billing and processing of claims and invoices with our health plan partners, providers, and patients. You will also ensure contracting and credentialing is complete and accurate for all health plan partners. You will work closely with our clinical and operations teams to manage billing and invoicing procedures and maintain accurate financial records. You will have managerial responsibilities with two direct reports. You will also work closely with our current and onboarding providers to ensure their CAQH, NPI profiles, licensure, etc. are all up to date and accurate. Your attention to detail, excellent organizational skills, and commitment to customer access will contribute to the financial stability and success of FamilyWell in tackling the perinatal mental health crisis.

Compensation: $90,000-95,000 / year with benefits

Location: Remote

Key Responsibilities:

Management:

• Manage two direct reports that are responsible for billing and insurance verification.
• Set clear goals and expectations for team members, aligning individual contributions with overall departmental objectives.
• Delegate tasks effectively, ensuring team members have the necessary resources and support to achieve their assigned goals.

Contracting/Credentialing/Payor Enrollment:

• Create, maintain and organize payor and provider document copies, NPPES/Licensing Board/CAQH/DEA and other required profiles, as well as files that are accessible to internal stakeholders.
• Does ongoing monthly verification of licensure, OIG, SAM, etc.
• Prepare and submit individual provider applications, rosters, and group applications for payor enrollment.
• Prepare and submit demographic updates as needed.
• Follow up in a timely manner to check status of submitted applications.
• Maintains open communication with providers, payers, and internal stakeholders to resolve credentialing and enrollment issues related to provider files.
• Maintains internal payer trackers for internal stakeholder visibility.

Billing and Invoicing:

• Ensure invoices and claims are properly documented, approved, and sent on schedule.
• Generate accurate and timely invoices for clients and partners.
• Provide member/insurance revenue management support throughout the revenue cycle, to include but not limited to: Claims Management, Accounts Receivable, Payment Posting and Denials Management

Financial Recordkeeping:

• Maintain organized financial records, including invoices and bills.
• Collaborate on reconciling accounts and resolving discrepancies.

Denial Management:

• Timely follow up with health plan partners on outstanding claims
• Submission of corrected claims and appeals as applicable.

Collections:

• Generate member statements and work with members to collect and resolve past due balances.

Reporting and Analysis:

• Assist in generating regular reports on payment status and financial performance.
• Analyze data to identify trends and areas for improvement.

Compliance and Documentation:

• Ensure adherence to financial regulations and policies.
• Maintain accurate documentation of payment processes.

Customer Success:

• Provide empathetic and compassionate customer service to families who may be struggling to meet payment obligations.
• Resolve payment disputes or concerns professionally and courteously.
• Maintain open communication with providers, payers, and internal stakeholders to resolve insurance eligibility and benefits, as well as claims issues.

Qualifications:

• 2+ years managing people required.
• 2+ years of experience as a revenue cycle specialist, payment coordinator, accounts receivable specialist, or a similar role required.
• 2+ years of behavioral health billing experience required.
• 2+ years of experience doing credentialing and payor enrollment required.
• 1+ years of experience working with MA, NH, TX and CT payers preferred.
• Excellent attention to detail and accuracy in data.
• Strong organizational and time management skills to handle multiple tasks and deadlines effectively.
• Strong understanding of billing and invoicing processes.
• Strong understanding of credentialing and payor enrollment processes.
• Familiarity with financial software and proficiency in using accounting systems.
• Excellent communication and interpersonal skills.
• Knowledge of relevant health care or financial regulations and compliance requirements.
• Prior experience in the healthcare or mental health industry is a plus.
• Highly independent, proactive, resilient, and empathetic.

The above is a summary of the role, not an exhaustive list. If you think that you have most of the above but not everything, please apply. We'd love to hear from you.