Revenue Cycle Management Specialist - Care Navigation (Medicare/CHI/PIN) presso 2070Health

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.