Sr RCM Specialist
Sr RCM Specialist
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$ 49976 - 68717
1 Vacancy
Job Description
Overview
This role will partner with business leaders to improve and deliver positive change throughout all revenue cycle processes. This role will collaborate with the RCM supervisor RCM Sr. Mgr./Mgr. to review the quality efficiency and productivity of our vendor partners. The Sr. RCM Specialist will work to improve the accuracy and effectiveness of revenue cycle processes through leading account audits data analysis training sessions and team/vendor meetings to name a few. This position will also be responsible for maintaining ATIs policies and procedures as it relates to their focused area within the revenue cycle. This role will be the subject matter expert in their focused area of the revenue cycle and collaborate with other process leaders to resolve process breakdowns.
Responsibilities
Assist in the summarizing of audit data to identify process improvement opportunities and creating Service Level Agreement (SLA) quality reporting.
Provide ongoing monitoring of standards by conducting audits of all revenue cycle processes vendors and technology. Performs timely reviews of patient accounts and remittances for denials to determine root cause and appropriateness of actions and leads corrective action plans
Provide subject matter guidance to ATI team members and offshore vendor partner teams.
Prepares schedules and leads collaboration / training sessions for onshore and offshore team members in conjunction with the RCM Supervisor to address quality concerns or optimize revenue cycle processes.
Monitor KPI & SLA metrics to ensure department is achieving monthly/quarterly/yearly targets. Works with RCM Supervisor to develop performance improvement plans for offshore vendor partners to optimize projects
Develops detailed and summary reports on a regular basis which are specific to revenue cycle process and key indicators
Responsible for maintaining all policies and standard operating procedures to improve efficiencies leading to updates to the audit tools
Stay current with and ensure adherence to payor guidelines policies and regulations continuously monitoring changes and updates to maintain compliance and optimize revenue cycle management. Responsible for communicating with payors.
Qualifications
Measurable Scope and Accountability
The Sr. RCM Specialist will need understanding of all revenue cycle processes but will be assigned to one of the following focused areas: Financial Clearance Central Business Office Commercial/Govt/SP AR Follow-up or WC/API AR Follow-up.
Minimum Education
Required:
High School Diploma GED or suitable equivalent
Preferred:
Associate / bachelors degree
Minimum Experience
Required:
5 years of healthcare experience in clinical or office setting
3 years of healthcare revenue cycle experience
Offshore revenue cycle vendor experience
Preferred:
5 years of healthcare revenue cycle experience
Experience in service line of RCM
Data analyst experience
Physical Therapy RCM experience
Lead Claim Denial and/or process auditing teams
Knowledge Skills and Abilities
Excellent in Microsoft Office applications capable of creating detailed analyses using pivot tables and other formulas/features within Excel.
Strong attention to detail to ensure the accuracy of data with the patient account.
Ability to prioritize and manage multiple tasks simultaneously.
Excellent interpersonal and communication skills both oral and written
Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency and accuracy.
Virtual Employee
Salary Range
Location/Org Data : Dept Number
Required Experience:
Senior IC
Employment Type
Full-Time
