Adia Health · 5 hours ago
Credit Risk Manager
United States
Full-time
Remote
Senior Level
5+ years expAdia Health is a fast-growing healthcare technology company transforming lab diagnostics for hospitals and medical groups. They are seeking a Credit Risk Manager to establish and manage the credit risk framework for healthcare receivables factoring, evaluating creditworthiness and developing underwriting policies.
Computer Software
Responsibilities
Assess the creditworthiness of prospective medical group clients using financial statements, credit bureau data, payment history, UCC filings, business ratings, and healthcare-specific risk indicators
Evaluate payer mix composition and reimbursement risk across Medicare, Medicaid, and commercial insurance carriers
Analyze medical billing data to assess claim denial rates, aging trends, and reimbursement cycle timing
Approve credit limits and funding structures in accordance with company credit policies
Own the KYC and UCC filing process during client onboarding to ensure proper security interest perfection
Identify red flags, including fraudulent activity, unsustainable payer concentrations, excessive denials, or deteriorating financial conditions
Conduct deep-dive research on high-risk medical specialties, payer relationships, and healthcare market dynamics
Understand medical billing workflows, claim submission processes, and payer adjudication timelines
Assess risk associated with different medical specialties, procedure types, and payer contracts
Monitor changes in reimbursement rates, payer policies, and healthcare regulatory environment
Evaluate impact of claim denials, prior authorizations, and billing compliance issues on collectability
Work with RCM teams to understand disputed claims and provide risk-adjusted reimbursement probability assessments
Review existing account performance including AR aging, collection trends, denial rates, and concentration risk
Monitor client funding activity to ensure compliance with approved credit limits and advance rates
Track payer remittance patterns and identify early warning signs of reimbursement delays
Recommend limit adjustments, advance rate modifications, or account holds based on deteriorating trends
Manage reserve requirements and assess appropriate haircuts for different receivable types
Develop and refine credit policies, underwriting guidelines, and risk scorecards specific to healthcare factoring
Maintain and enforce internal credit policies and risk thresholds
Ensure compliance with UCC requirements, factoring regulations, and healthcare finance best practices
Communicate credit decisions and rationale clearly to internal stakeholders (sales, onboarding, operations, finance)
Build strong relationships with internal business stakeholders to balance risk management with growth objectives
Prepare regular reports on portfolio exposure, reimbursement trends, payer concentration, and risk metrics
Track KPIs including approval turnaround time, portfolio quality, charge-offs, denial rates, and fraud incidents
Apply data analysis techniques to identify patterns and provide actionable insights to management
Use internal systems (ERP, Adia OS, credit platforms, medical billing integrations) to document decisions and maintain data accuracy
Serve as the technical expert on credit risk systems and tools
Stay current on healthcare industry trends, reimbursement policy changes, and regulatory developments
Research best practices in healthcare factoring and medical receivables financing
Contribute to process improvements and automation of credit workflows
Mentor junior team members as the credit function scales
Qualification
Required
Bachelor's degree in Finance, Accounting, Economics, Business, or related field
5-7 years of experience in credit analysis with at least 2 years in healthcare finance, medical receivables factoring, healthcare factoring, invoice factoring, asset-based lending, or commercial healthcare lending
Deep understanding of medical billing and reimbursement cycles including Medicare, Medicaid, and commercial insurance
Strong knowledge of credit principles, financial statement analysis, and risk assessment methodologies
Experience evaluating payer mix, claim denial risk, and healthcare receivables collectability
Ability to interpret credit reports, UCC filings, and industry-specific risk platforms (e.g., SaferWatch, Ansonia, Experian)
Familiarity with medical billing platforms such as Athena, ECW, AdvancedMD, or similar EMR/practice management systems
Understanding of healthcare compliance requirements (HIPAA, billing regulations, payer credentialing)
Exceptional attention to detail with strong quantitative and analytical skills
Excellent communication skills—able to explain complex credit decisions clearly and concisely to both technical and non-technical audiences
Advanced proficiency with Excel and financial analysis tools
Ability to work independently and build processes from the ground up in a fast-paced startup environment
Preferred
Experience with invoice factoring, accounts receivable financing, or asset-based lending
Knowledge of healthcare revenue cycle management (RCM) operations
Familiarity with fraud detection tools and payment risk monitoring in healthcare
Understanding of value-based care models and alternative payment arrangements
Experience working cross-functionally with sales, operations, and product teams in a growth-stage company
Benefits
Comprehensive benefits: medical, dental, vision, and 401(k)
Unlimited PTO
Fully remote—work from anywhere with a globally distributed team
Opportunity to build and lead the credit function at a high-growth healthcare fintech
Collaborative culture focused on integrity, innovation, and improving healthcare delivery
Company
Adia Health
Adia is transforming healthcare by combining proprietary clinical AI with instant provider payments, solving both the diagnostic accuracy crisis and the financial barriers that plague medical providers.
11-50 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase