Cayaba Care

About Us

The US is one of the most dangerous developed countries to give birth and these poor maternal-fetal outcomes disproportionately impact minority women and underserved populations across major US cities.

Cayaba Care’s mission is to improve outcomes in communities by reimagining how maternity care is delivered. Our team is focused on building technology-enabled solutions to deliver clinical and non-clinical services in-home or in-office. The Cayaba Care care model focuses on integration not replacement of patients’ primary Obstetric provider and reducing any barriers to the patient receiving the recommended care. We are a multi-disciplinary team and recognize the importance of behavioral health to overall health.

You will be a good fit for Cayaba Care if you:

  • Have a passion for doing impactful work
  • Are empathetic, patient-centered, and enjoy working with patient with complex needs
  • Hold yourself accountable for making and exceeding established goals
  • Have a deep commitment to diversity and inclusion

What You’ll Do

  • Design and implement Cayaba Care’s Revenue Cycle Model.
  • Manage Cayaba Care Billing Activities including all phases of coding, data entry, charge entry and other claim activity to ensure that services are billed on a timely and consistent basis.
  • Manage credentialing and billing team of credentialing and billing employees providing support, guidance and accountability.
  • Coordinate with company leadership as well as credentialing team members on updating lists of insurance companies, insurance contracts, fee schedules for staff reference and information.
  • Serve as a point of contact for collections activities.
  • Maintain contact and communication with Medicaid, Managed Care Organizations and commercial insurance companies to promote a positive response when questions and problem solving opportunities arise; always establishing contact with newly appointed representatives.
  • Ensure that the Billing Department follows all necessary HIPAA regulations to protect patient information.
  • Bring any compliance/regulatory concerns and major adverse trending A/R issues to the immediate attention of the CFO.

Who You Are

  • An expert in professional fee billing, reimbursement and third party payer regulation and medical terminology.
  • Have experience establishing Revenue-cycle processes in start-up/innovative healthcare organizations.
  • Knowledgeable of Pennsylvania and New Jersey Medicaid; Medicaid Managed Care Plans.
  • Possess strong problem-solving skills and attention to detail.
  • A leader who is passionate about the Cayaba Care mission and demonstrates the organization's values.

What You’ll Get

  • Hours: Full-Time
  • Benefits: Health, Dental, Life Insurance, 401K
  • Role type: Hybrid
  • People Manager: Yes

Required Qualifications

  • Bachelor's Degree in Business, Healthcare Administration or equivalent and minimum of five (5) years of medical billing experience
  • Minimum of three years in a supervisory role
  • Billing and coding experience (Obstetrics highly preferred)
  • Physician credentialing process knowledge/expertise

Preferred Qualifications

  • Experience with AthenaHealth
  • Physician credentialing process knowledge/expertise in Pennsylvania, New Jersey and New York
  • Experience in a high-growth, unstructured environment where there has been success in implementing structure, reliable operations and continuous improvement