Clinical Revenue Performance Specialist

We have an exciting and unique opening for a Clinical Revenue Performance Specialist with Luna!
This position will play a critical role in optimizing revenue cycle workflows, improving revenue performance, and ensuring a holistic view of the revenue cycle for clinical initiatives. This role will also focus on driving performance improvements in Remote Therapeutic Monitoring (RTM), Merit-Based Incentive Payment System (MIPS) reporting, and identifying opportunities for clinical operations to enhance revenue optimization strategies. This is a highly collaborative role working closely across all Clinical, Revenue Cycle Management (RCM), Compliance and Finance teams. The ideal candidate will have a strong understanding of revenue cycle systems, outpatient coding, and billing guidelines, as well as excellent communication and analytical skills. A perfect opportunity for those with a clinical background looking to do something different in the revenue and documentation space!

Key Responsibilities

• Champions revenue cycle optimization initiatives across Luna to improve clinical processes that support revenue cycle performance.
• Works closely with Clinical and RCM teams to align revenue optimization efforts with clinical operations and reimbursement policies.
• Assists in developing strategies to improve overall revenue performance and applies knowledge of ICD 10 and CPT coding to perform in-depth analysis of root cause issues.
• Partners with the Quality Reporting Manager to ensure compliance with Remote Therapeutic Monitoring and  MIPS requirements, optimizing documentation and coding strategies to maximize reimbursement and reduce penalties.
• Supports Quality Reporting Manager and other stakeholders to determine feasibility and cost saving opportunities, in MIPS service fees while enabling scalable submission for additional states and increased patient volumes..
• Collaborates with RTM Managers in driving success of RTM code reimbursements and suggests enhancements in processes, creating a scalable and sustainable service line.
• Collaborates and translates data optimizations with the Clinical team and Luna systems to design or improve workflows that enhance revenue capture and reporting.
• Works with billing team to review and analyze payer correspondences related to denials that can be appealed; participates in training and other in-servicing sessions for end-user education.
• Leverages analytics to identify revenue trends, assess key performance indicators, and implement clinical solutions to drive revenue cycle improvements.
• Partners with Quality Reporting Manager and Finance to develop improved reporting of revenue gains linked to quality performance metrics.

What You Can Offer Luna?

• Bachelor's degree in Healthcare Administration, Business, or a related field preferred.
• At least 3-5 years of experience in revenue cycle management, coding, billing, or clinical operations.
• Clinical, business or financial analysis experience preferred.
• Strong understanding of medical coding systems (ICD-10, CPT).
• Clinical experience (PT, OT, PTA) is a plus but not required. However, familiarity with clinical workflows and documentation is highly desirable.
• Expertise in clinical documentation guidelines and revenue cycle management best practices.
• Experience with Remote Therapeutic Monitoring (RTM) and Merit-Based Incentive Payment System (MIPS) reporting is a plus.
• Proficiency with electronic health records (EHR) and revenue cycle management software.
• Analytical skills to identify trends and patterns in revenue performance data.
• Excellent communication and collaboration skills to work with clinicians and billing teams.
• Ability to analyze, report on, and provide actionable insights from financial and clinical operational data.

What Luna Can Offer You:

• Hybrid/remote work
• Employee referral program
• Medical, dental and vision benefits on the 1st of the month following start
• 401k
• Stock options
• Unlimited PTO
• Enormous opportunity to grow with a start up well positioned for tremendous upside and career trajectory