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
• 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: $60-65K/year

Career Level: M2/M3 based on experience

 

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,