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Salary: USD 120,000 - 135,000 / annual
Daymark Health is a value-based oncology company transforming cancer care through a comprehensive platform combining dedicated care navigation, symptom-focused support, behavioral health, and social resources with evidence-based interventions and hybrid in-person/virtual care.
You will build and lead the Revenue Cycle Management function from the ground up, owning end-to-end operations including professional billing, third-party vendor management, claims processing, and risk adjustment. This is a hands-on operator role with strategic scope.
Key responsibilities include:
**Revenue Cycle Operations**: Lead RCM across all payer types with focus on Original Medicare and value-based contracts. Establish patient billing workflows balancing collection integrity with patient experience. Manage third-party billing vendor relationships, performance monitoring, contract compliance, and optimization. Own claims and clearinghouse platform operations including submission workflows, rejection/denial management, and resubmission processes. Establish and track KPIs: clean claim rate, denial rate, days in AR, net collection rate.
**Risk Adjustment & Credentialing**: Partner with Clinical Operations, Product, and Data to ensure risk adjustment workflows are embedded in tooling from chart prep through billing submission. Support end-to-end provider enrollment including NPI registration, CAQH maintenance, and payer credentialing. Track credentialing status and expiration timelines. Build onboarding workflows sequencing credentialing with provider start dates.
**AI & Technology**: Identify and evaluate AI-enabled RCM tools including automated coding assistance and denial prediction. Partner with Product and Data to pilot and implement capabilities improving throughput and accuracy.
**Operational Infrastructure**: Translate billing and compliance requirements into scalable workflows. Establish audit and QA processes for coding accuracy and billing integrity. Drive cross-functional resolution of execution gaps.
You bring direct experience managing third-party billing vendors and claims/clearinghouse platforms, familiarity with HCC coding and risk adjustment workflows, and genuine interest in AI applications in RCM. Healthcare startup or high-growth company experience is a plus. You are strategic and execution-oriented, analytical, effective cross-functional partner, energized by building from scratch, and have high standards for compliance and billing integrity.
