About Rialtic

Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors including Oak HC/FT, F-Prime Capital, Health Velocity Capital and Noro-Moseley Partners, Rialtic's best-in-class payment accuracy product brings programs in-house and helps health insurance companies gain total control over processes that have been managed by disparate and misaligned vendors. Currently working with leading healthcare insurers and providers, we are tackling a $1 trillion problem to reduce costs, increase efficiency and improve quality of care. For more information, please visit www.rialtic.io.

The Role

We are looking for an experienced Content Portfolio Manager that will be a subject matter expert and help build and manage a portfolio of “content” claims processing edits that are the basis for our solution.

You Are:

• Ambitious. You thrive in ambiguity and can bring clarity to your execution. You are eager to make an impact with minimal guidance and oversight. You thrive in a fast-moving, dynamic, hyper-growth, coach/player environment.
• Fact-driven. Content Portfolio Managers conduct research, make recommendations, and take action.
• Analytical. You have strong analytical and logistical skills. You have significant experience in structured design techniques and collaborating with engineering producing and adjusting software.
• Life-Long Learner. Curious to learn, explore new approaches, create new programs and processes and share them with peers and other departments.
• Efficient. You have strong execution skills and action bias. You are able to independently manage highly interdependent, complex projects, keep various work streams on track and juggle shifting priorities with tight turnaround times.
• A team player. Content Portfolio Managers collaborate across the Content, Product and Engineering teams and with every team at Rialtic. You are able to work with a range of disciplines to execute on your work.

You Will:

• Review healthcare policies and determine the logics to create based on strategic and technical considerations
• Create functional designs and test claims from concept through validation and maintenance
• Review, edit and finalize designs and test claims assigned to content analysts
• Mentor and coach content analysts on conceptualizing, creating and delivering claims processing edits and improving claims processing designs and test claims
• Create and manage special projects and programs from concept through execution and maintenance.
• Provide expertise to guide the prioritization and roadmap of edits pertinent to your top knowledge areas
• Develop a Roadmap to guide the creation of your portfolio of claims processing edits
• Perform sampling and validation with client data of beta and in-production claims edits
• Troubleshoot edits that do not function as expected and collaborate with Engineering teams to resolve and adjust design and test claims to make edits function as intended.

You Have:

• 3-6 years of work experience in claims editing with a health plan, claims editing vendor, or payer
• Coding, Billing, and/or Auditing Credentials or any certified coding specialty
• Worked with claim forms (CMS 1500, 837, 835) and understand their fields
• Worked with edits - developed them, reviewed them, taken them in and then approved them
• In depth knowledge of how and why a policy is made and top issues in claims billing, editing and coding
• Expertise in multiple medical coding and/or billing specialties
• Experience interpreting medical coding policies or payment accuracy
• Created, launched and managed special projects, programs and or products

Rialtic Values

• High Integrity
  • Do the right thing. Provide candid feedback. Be humble and respectful.
• Customer Value Comes First
  • Delivering value to our customers is our North Star.
• Work as One Team
  • Collaborative, inclusive environment to advance our mission.
• Be Bold & Accountable
  • Speak up. Take accountability. Continually improve.
• Pursuit of Excellence
  • Innovate, iterate and chase the best possible outcomes.
• Take Care of Yourself & Others
  • Prioritize the health and wellbeing of yourself and your teammates.

Rialtic Benefits:

• Freedom to work from wherever you work best and a home office stipend to make it happen
• Meaningful equity and 401k matching
• Unlimited PTO, comprehensive health plans and wellness reimbursements
• Comprehensive health plans with generous contribution to premiums
• Mental and physical wellness support through TalkSpace, Teladoc and One Medical subscriptions

We are headquartered in Atlanta, but we are remote friendly.