Revenue Cycle Management Specialist - Care Navigation (Medicare/CHI/PIN) Job at 2070Health, San Francisco, CA

UnV4bXRMMjFnMEZxZFZpc0Q5Y3R4d08xYlE9PQ==
  • 2070Health
  • San Francisco, CA

Job Description

About 2070 Health

W Health Ventures has set up India's first healthcare focused Venture Studio called  2070Health - an innovation platform that builds transformative healthcare companies from scratch by discovering disruptive opportunities in whitespaces. Distinct from the accelerator approach, our venture studio is closely involved in idea generation, day-to-day operations, and strategic decisions of growing the new business. Companies incubated in the last 24 months includeEverbright Health, Elevate Now, Nivaan Care, Reveal Healthtech , BabyMD and Everhope Oncology.

This role is for a company we are incubating within the studio.

The Role

This role is part of a new company we are actively incubating in the US care navigation space. We embed fully managed care navigation, including staffing, technology, and compliance, into provider practices so they can stand up CMS-reimbursable Community Health Integration (CHI) and Principal Illness Navigation (PIN) programs for their Medicare patients with zero upfront cost. We exist to make a brand-new Medicare benefit easy to deliver and easy to bill.

This is a chance to be on the ground floor of something being built from scratch.

We are hiring a Revenue Cycle Management (RCM) Specialist with hands-on, in-the-claims experience billing Community Health Integration and Principal Illness Navigation  (HCPCS G0019, G0022, G0023, G0024) for Medicare beneficiaries. This is not a generic billing role. You will own the end-to-end RCM motion for Kero's care navigation services and be the person who makes sure our claims get paid clean, on time, and with zero compliance risk.

What You'll Own

· Own end-to-end RCM for Medicare CHI and PIN claims, from eligibility verification through payment posting and reconciliation.

· Audit charge capture against time logs and clinical documentation to ensure clean CHI / PIN submissions.

· Work clearinghouse edits, manage denials, and run appeals to closure.

· Run AR aging, payment posting, and ERA / EOB reconciliation; flag payer and MAC-specific trends to leadership.

· Partner with care navigators and clinicians to close documentation gaps, and report KPIs back to the team.

Requirements

· 2 to 5 years of hands-on US medical billing / revenue cycle experience.

· Direct, demonstrable experience billing Medicare Part B claims. Non-negotiable.

· Hands-on experience with the full CHI and PIN code family:

§ PCM: 99424–99427

§ CCM: 99490, 99439, 99487, 99489

§ TCM: 99495, 99496

§ BHI / CoCM: 99484, 99492–99494

§ RPM / RTM: 99453–99458

§ APCM: G0556, G0557, G0558

§ SDOH Risk Assessment: G0136

§ CCM initiating visit: G0506

§ RHC / FQHC general care management: G0511



· Fluent in HCPCS, CPT, and ICD-10-CM coding for chronic and serious-illness populations.

· Comfortable with EHR / PMS (like Athenahealth, eClinicalWorks, AdvancedMD, DrChrono, Epic, Cerner, Kareo, or similar).

· Strong written and verbal English communication.

· US work authorization.

· Prior experience at a care-navigation company, digital-health platform, value-based-care provider group, or specialty practice that bills CHI / PIN at scale. Current and former employees of such organizations are encouraged to apply.

Benefits

Competitive base salary, health / dental / vision, 401(k), fully remote, flexible PTO, and an annual learning & certification stipend.

Job Tags

Full time, Remote work, Flexible hours

Similar Jobs

EssilorLuxottica Group

LensCrafters - Licensed Optician Job at EssilorLuxottica Group

 ...driving the transformation of the eyewear and eyecare industry. Discover more by following us on LinkedIn! The Licensed Optician delivers the brand value proposition & helps establish LensCrafters as the premier destination for all vision needs within the... 

BJC Healthcare

Clinical Educator - Cardiac Telemetry Job at BJC Healthcare

 ...providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. ~...  ...has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed... 

Stand-By Personnel

Pipe Welder Job at Stand-By Personnel

 ...industry-standard weld tests. The Pipe Welder position involves working from blueprints and job specifications in an industrial fabrication environment. Requirements Ability to pass a 6G welding test (pipe or plate) Experience with one or multiple welding... 

Planet Fitness

Fitness Facility Maintenance and Repair Technician Job at Planet Fitness

 ...Paid time off ~ Wellness resources Job Title: Facilities Technician Reports To: VP / Facilities Supervisor Travel...  ...The Facilities Technician is responsible for the service, repair, and preventative maintenance of exercise machines, spa amenities... 

Covance Inc.

Genetic Counselor Job at Covance Inc.

 ...Labcorp is seeking an onsite Genetic Counselor to join our team to support a busy Maternal Fetal Medicine Practice in Los Angeles,...  ...Job Responsibilities: Provide onsite prenatal genetic counseling services for MFM practice in Los Angeles, CA Have the opportunity...